Chronic respiratory disease burden rises in the WHO Western Pacific Region despite falling age-standardized mortality
A GBD 2023 analysis in Med Research highlights aging, COPD, tobacco smoking and air pollution as central priorities
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Time trends are shown in separate panels for (A) age‐standardized incidence rate (ASIR), (B) age‐standardized prevalence rate (ASPR), (C) age‐standardized mortality rate (ASMR), and (D) age‐standardized DALY rate (ASDR). Solid lines represent point estimates, and shaded regions indicate 95% uncertainty intervals. EAPC values with 95% confidence intervals are shown within each panel. All rates are expressed per 100,000 population.
view moreCredit: Zhang Yue | Yi‐Cheng Fu | Wen Zuo | Li‐Na Wang| Xing‐Xing Suo | Peng Sun | Jin‐Hui Bian| Ming‐Yan Wang
A new analysis in Med Research uses the Global Burden of Disease 2023 study to assess chronic respiratory diseases (CRDs) across 37 countries and territories in the WHO Western Pacific Region from 1990 to 2023. The study examined incidence, prevalence, deaths, disability-adjusted life years (DALYs), age-standardized rates, disease subtypes and selected modifiable risk factors.
By 2023, CRDs accounted for 22.0 million incident cases, 155.9 million prevalent cases, 1.4 million deaths and 29.9 million DALYs in the region. Compared with 1990, absolute numbers increased across all major indicators, largely reflecting population growth and aging. At the same time, age-standardized mortality and DALY rates declined substantially, with estimated annual percentage changes of -2.67% and -2.31%, respectively.
The burden was concentrated among older adults and remained higher in males. COPD dominated the disease composition, accounting for 75.3% of CRD-related DALYs in 2023. Among the selected risk factors, tobacco smoking and air pollution were the leading modifiable contributors, followed by occupational exposure.
Illustrative comparisons of China, Japan, the Republic of Korea, Vietnam, the Philippines and Australia showed marked heterogeneity within the region. The findings suggest that respiratory-health strategies in the Western Pacific Region should combine sustained tobacco control, cleaner air, stronger occupational protection, earlier detection and long-term management of chronic respiratory conditions.
Because the analysis relies on GBD modelled estimates, country-level differences in diagnostic access, data completeness and cause-of-death coding should be considered when interpreting cross-country comparisons.
Journal
Med Research
Method of Research
Data/statistical analysis
Subject of Research
People
Article Title
Chronic Respiratory Diseases in the 2023-Defined WHO Western Pacific Region: Burden and Trends From GBD 2023
Even brief e-cigarette use can cause lasting lung damage and weaken defenses against respiratory viruses, study finds
Just days of e-cigarette vapor exposure can injure the lungs' most delicate tissue and leave it more vulnerable to viral infection, according to a study led by National Jewish Health researchers and published in JCI Insight.(Opens in a new window)
The research team studied human lung epithelial and endothelial cells, along with precision-cut human lung tissue, all taken from the distal lung — the deep, delicate region where oxygen passes into the bloodstream. They exposed these tissues to e-cigarette vapor alone, and separately tested vapor exposure followed by infection with a respiratory virus, in preclinical models. Within 24 hours, e-cigarette vapor damaged the protective barrier of the distal lung, triggered cellular stress, impaired cells’ internal process for clearing damaged components, slowed cell growth and repair, and increased cell death.
Strikingly, signs of lung stress persisted 10 days after just a five-day exposure period ended. The team observed lasting changes in barrier function, tissue remodeling, and Th1 immunity — a branch of the immune system critical to fighting viral infections.
Prior vaping exposure also increased SARS-CoV-2 viral burden and suppressed several antiviral genes following infection.
“Our findings suggest that even short-term vaping exposure can initiate injury in the deepest and most delicate regions of the lung,” said senior author Irina Petrache, MD, pulmonologist and chief of the Division of Pulmonary, Critical Care and Sleep Medicine at National Jewish Health. “Importantly, some effects persisted after exposure ended and altered the immune response to a subsequent viral infection.”
The findings, which will need to be confirmed in future studies in people, point to biological mechanisms that may help explain why vaping has been linked to lung injury and greater susceptibility to respiratory infections. The researchers noted that repeated exposure could potentially contribute to chronic lung disease by sustaining cellular injury and disrupting normal repair.
National Jewish Health is the leading respiratory hospital in the nation delivering excellence in multispecialty care and world class research. Founded in 1899 as a nonprofit hospital, National Jewish Health today is the only facility in the world dedicated exclusively to groundbreaking medical research and treatment of children and adults with respiratory, cardiac, immune and related disorders. Patients and families come to National Jewish Health from around the world to receive cutting-edge, comprehensive, coordinated care. To learn more, visit njhealth.org or the media resources page.
Journal
JCI Insight
Article Title
E-cigarette exposure triggers distal lung cell injury, persistent lung stress response, and antiviral immune suppression
