Severity of chronic obstructive pulmonary disease with ‘exacerbator with emphysema phenotype’ is associated with potential biomarkers

2019 ◽  
Vol 96 (1131) ◽  
pp. 28-32 ◽  
Author(s):  
Wendong Hao ◽  
Manxiang Li ◽  
Yunqing Zhang ◽  
Cailian Zhang ◽  
Ping Wang

ObjectiveThe present study was designed to investigate the biomarkers levels of fractalkine (FKN), neutrophil elastase (NE) and matrix metalloproteinase-12 (MMP-12) in chronic obstructive pulmonary disease (COPD) with ‘exacerbator with emphysema phenotype’ and to evaluate the associations between the biomarkers levels and the severity of disease by spirometric measurements.MethodsA total of 84 COPD patients and 49 healthy controls were enrolled in our study. ELISA were utilised to detect the FKN, MMP-12 and NE in serum from all subjects.ResultsFKN (p<0.001), NE (p=0.039) and MMP-12 (p<0.001) in serum of COPD patients showed higher levels than that of healthy control subjects. Serum FKN (p<0.001), MMP-12 (p<0.001) and NE (p=0.043) levels were significantly higher in severe and very severe COPD patients than that in mild and moderate COPD patients. Circulating FKN, MMP-12 and NE expression levels were significantly elevated (p<0.001) in COPD smokers compared with COPD non-smokers. The smoke pack years were negatively correlated with FEV1%pred (r=−0.5036), FEV1/FVC ratio (r=−0.2847) (FEV, forced expiratory volume; FVC, forced vital capacity). Similarly, we observed a strong positive correlation between the smoke pack years and serum levels of FKN (r=0.4971), MMP-12 (r=0.4315) and NE (r=0.2754). FEV1%pred was strongly negatively correlated with cytokine levels of FKN (r=−0.4367), MMP-12 (r=−0.3295) and NE (r=−0.2684). Likewise, FEV1/FVC ratio was negatively correlated with mediators of inflammation levels of FKN (r=−0.3867), MMP-12 (r=−0.2941) and NE (r=−0.2153).ConclusionSerum FKN, MMP-12 and NE concentrations in COPD patients are directly associated with the severity of COPD with ‘exacerbator with emphysema phenotype’. This finding suggests that FKN, MMP-12 and NE might play an important role in the pathophysiology of COPD.

2021 ◽  
Vol 10 (2) ◽  
pp. 269
Author(s):  
Elisabetta Zinellu ◽  
Alessandro G. Fois ◽  
Elisabetta Sotgiu ◽  
Sabrina Mellino ◽  
Arduino A. Mangoni ◽  
...  

Background: Chronic obstructive pulmonary disease (COPD) is a progressive condition characterized by chronic airway inflammation and lung parenchyma damage. Systemic inflammation and oxidative stress also play a role in the pathogenesis of COPD. Serum albumin is a negative acute-phase protein with antioxidant effects and an important marker of malnutrition. The aim of this meta-analysis was to investigate differences in serum albumin concentrations between patients with stable COPD and non-COPD subjects. Methods: A systematic search was conducted, using the terms “albumin” and “chronic obstructive pulmonary disease” or “COPD”, in the electronic databases PubMed and Web of Science, from inception to May 2020. Results: Twenty-six studies were identified on a total of 2554 COPD patients and 2055 non-COPD controls. Pooled results showed that serum albumin concentrations were significantly lower in COPD patients (standard mean difference, SMD = −0.50, 95% CI −0.67 to −0.32; p < 0.001). No significant differences were observed in SMD of serum albumin concentrations between COPD patients with forced expiratory volume in the 1st second (FEV1) < 50% and those with FEV1 > 50%. Conclusions: Our systematic review and meta-analysis showed that serum albumin concentrations are significantly lower in patients with stable COPD compared to non-COPD controls. This supports the presence of a deficit in systemic anti-inflammatory and antioxidant defense mechanisms in COPD.


2008 ◽  
Vol 15 (8) ◽  
pp. 437-443 ◽  
Author(s):  
Anderson Chuck ◽  
Philip Jacobs ◽  
Irvin Mayers ◽  
Darcy Marciniuk

BACKGROUND: There is evidence that combination therapy (CT) in the form of long-acting beta2-agonists (LABAs) and inhaled corticosteroids can improve lung function for patients with chronic obstructive pulmonary disease (COPD).OBJECTIVE: To determine the cost-effectiveness of using CT in none, all or a selected group of COPD patients.METHODS: A Markov model was designed to compare four treatment strategies: no use of CT regardless of COPD severity (patients receive LABA only); use of CT in patients with stage 3 disease only (forced expiratory volume in 1 s [FEV1] less than 35% of predicted); use of CT in patients with stages 2 and 3 disease only (FEV1less than 50% of predicted); and use of CT in all patients regardless of severity of COPD. Estimates of mortality, exacerbation and disease progression rates, quality-adjusted life years (QALYs) and costs were derived from the literature. Three-year and lifetime time horizons were used. The analysis was conducted from a health systems perspective.RESULTS: CT was associated with a cost of $39,000 per QALY if given to patients with stage 3 disease, $47,500 per QALY if given to patients with stages 2 and 3 disease, and $450,333 per QALY if given to all COPD patients. Results were robust to various assumptions tested in a Monte Carlo simulation.CONCLUSION: Providing CT for COPD patients in stage 2 or 3 disease is cost-effective. The message to family physicians and specialists is that as FEV1worsens and reaches 50% of predicted values, CT is recommended.


2018 ◽  
Vol 314 (2) ◽  
pp. H180-H187 ◽  
Author(s):  
U. W. Iepsen ◽  
G. W. Munch ◽  
C. K. Ryrsø ◽  
N. H. Secher ◽  
P. Lange ◽  
...  

Sympathetic vasoconstriction is blunted in exercising muscle (functional sympatholysis) but becomes attenuated with age. We tested the hypothesis that functional sympatholysis is further impaired in chronic obstructive pulmonary disease (COPD) patients. We determined leg blood flow and calculated leg vascular conductance (LVC) during 1) femoral-arterial Tyramine infusion (evokes endogenous norepinephrine release, 1 µmol·min−1·kg leg mass−1), 2) one-legged knee extensor exercise with and without Tyramine infusion [10 W and 20% of maximal workload (WLmax)], 3) ATP (0.05 µmol·min−1·kg leg mass−1) and Tyramine infusion, and 4) incremental ATP infusions (0.05, 0.3, and 3.0 µmol·min−1·kg leg mass−1). We included 10 patients with moderate to severe COPD and 8 age-matched healthy control subjects. Overall, leg blood flow and LVC were lower in COPD patients during exercise ( P < 0.05). Tyramine reduced LVC in both groups at 10-W exercise (COPD: −3 ± 1 ml·min−1·mmHg−1and controls: −3 ± 1 ml·min−1·mmHg−1, P < 0.05) and 20% WLmax(COPD: −4 ± 1 ml·min−1·mmHg−1and controls: −3 ± 1 ml·min−1·mmHg−1, P < 0.05) with no difference between groups. Incremental ATP infusions induced dose-dependent vasodilation with no difference between groups, and, in addition, the vasoconstrictor response to Tyramine infused together with ATP was not different between groups (COPD: −0.03 ± 0.01 l·min−1·kg leg mass−1vs. controls: −0.04 ± 0.01 l·min−1·kg leg mass−1, P > 0.05). Compared with age-matched healthy control subjects, the vasodilatory response to ATP is intact in COPD patients and their ability to blunt sympathetic vasoconstriction (functional sympatholysis) as evaluated by intra-arterial Tyramine during exercise or ATP infusion is maintained.NEW & NOTEWORTHY The ability to blunt sympathetic vasoconstriction in exercising muscle and ATP-induced dilation in chronic obstructive pulmonary disease patients remains unexplored. Chronic obstructive pulmonary disease patients demonstrated similar sympathetic vasoconstriction in response to intra-arterial Tyramine during exercise and ATP-induced vasodilation compared with age-matched healthy control subjects.


2021 ◽  
Author(s):  
Tai Joon An ◽  
Yeun Jie Yoo ◽  
Jeong Uk Lim ◽  
Wan Seo ◽  
Chan Kwon Park ◽  
...  

Abstract Background: The importance of evaluating the diaphragm muscle in chronic obstructive pulmonary disease (COPD) is widely accepted. However, the role of diaphragm ultrasound (DUS) in COPD is not fully understood. We set this study to evaluate the role of DUS for distinguishing the status of COPD. Methods: COPD patients who underwent DUS were enrolled between March 2020 and November 2020. The diaphragm thickening fraction (TFmax) and diaphragm excursion (DEmax) during maximal deep breathing were measured. Patients were divided into exacerbation and stable groups. Demographics, lung function, and DUS findings were compared between the two groups. Receiver operating characteristic (ROC) curve and univariate/multivariate logistic regression analyses were performed.Results: Fifty-five patients were enrolled. The exacerbation group had a lower body mass index (BMI) (20.9 vs. 24.2, p = 0.003), lower TFmax (94.8 ± 8.2% vs. 158.4 ± 83.5%, p = 0.010), and lower DEmax (30.8 ± 11.1 mm vs. 40.5 ± 12.5 mm, p = 0.007) compared to stable group. The areas under the TFmax (0.745) and DEmax (0.721) curves indicated fair results for distinguishing exacerbation. The patients were divided into low and high TFmax and DEmax groups based on calculated cut-off values. Low TFmax (odds ratio [OR] 8.40; 95% confidence interval [CI] 1.55–45.56) and low DEmax (OR 11.51; 95% CI 1.15–115.56) were associated with exacerbation after adjusting for age, sex, BMI, forced vital capacity and forced expiratory volume in 1 sec.Conclusion: TFmax and DEmax distinguished exacerbation from stable status. We describe the DUS cut-off values for determining an exacerbation status in this study.


2013 ◽  
Vol 3 (2) ◽  
pp. 42-45 ◽  
Author(s):  
K Begum ◽  
MK Begum ◽  
ZH Sarker ◽  
MRK Dewan ◽  
MJH Siddique

The aim of this study was to evaluate the serum level of total cholesterol, triglycerides (TG), low density lipoproteins (LDL) and high density lipoproteins, (HDL) in chronic obstructive pulmonary disease (COPD) patients admitted in National Institute of Disease of Chest and Hospital, Mohakhali, Dhaka during. January 2009 to January 2010. Twenty two patients with COPD and 22 healthy controls were included in this study. Total cholesterol, HDL and TG levels were determined with ILAB 1800 Chemistry Analyzer using ILAB test Reagents. LDL concentration was calculated using the Friedewald Equation. The mean level of TG was 150.04±29.66 mg/dl and 126.14±13.28 in COPD patients and healthy control, respectively. A statistically significant difference was found between the two groups (p<0.001). The mean level of TC was 181.83±20.11 mg/dl and 176.28±15.35 mg/dl in COPD patients and healthy control respectively (p<0.001). LDL level mean value was 116.12±14.26 mg/dl and 108.95±10.39 in COPD patients and control respectively (p<0.001). The mean value of HDL showed 38.79±2.4 in COPD patients and 39.014±1.56 in control. A statistically significance was also found between the two groups (p<0.001). Our results showed that the values of TC, TG, LDL were higher than healthy control that is highly significant statistically. On the other hand, the was significantly decreased HDL level compared with controls. DOI: http://dx.doi.org/10.3329/bjmb.v3i2.13810 Bangladesh J Med Biochem 2010; 3(2): 42-45


2020 ◽  
Author(s):  
Jianjun Wu ◽  
Hong-ri Xu ◽  
Ying-xue Zhang ◽  
Yi-xuan Li ◽  
Hui-yong Yu ◽  
...  

Abstract Objective: To investigate the clinical characteristics between the frequent exacerbator with chronic bronchitis (FE-CB) phenotype and the non-exacerbator (NE) phenotype among patients with chronic obstructive pulmonary disease (COPD). Methods: We searched CNKI, Wan fang, Chongqing VIP, China Biology Medicine disc, PubMed, Cochrane Library, and EMBASE databases for relevant studies published as of April 30, 2019. All studies that investigated COPD patients with the FE-CB and NE phenotypes and which qualified the inclusion criteria were included. Cross-Sectional/Prevalence Study Quality recommendations were used to measure methodological quality. RevMan5.3 software was used for meta-analysis. Results: Ten case-control studies (n=8848) were included. Compared with the NE phenotype, patients with the FE-CB phenotype showed significantly lower forced vital capacity percent predicted (FVC%pred) [mean difference (MD) -6.69, 95% confidence interval (CI) -7.73–-5.65, P<0.001, I2=5%], forced expiratory volume in one second percent predicted (FEV1%pred) (MD -8.50, 95% CI -11.36–-5.65, P<0.001, I2=91%), and forced expiratory volume in one second/forced vital capacity (FEV1/FVC) (MD -3.76, 95% CI -4.58–-2.95,P<0.001, I2=0%); in contrast, the quantity of cigarettes smoked (pack-years) (MD 3.09, 95% CI 1.60–4.58, P<0.001, I2=41%), COPD assessment test (CAT) score (MD 5.61, 95% CI 4.62–6.60, P<0.001, I2=80%), modified Medical British Research Council (mMRC) score (MD 0.72, 95% CI 0.63–0.82, P<0.001, I2=57%), exacerbations in previous year (2.65, 95% CI 2.32–2.97, P<0.001, I2=91%), body mass index (BMI), obstruction, dyspnea, exacerbations (BODEx) (MD 1.78, 95% CI 1.28–2.28, P<0.001, I2=91%), I2=34%), and Charlson comorbidity index (MD 0.47, 95% CI 0.37–0.58, P<0.001, I2=0] were significantly higher in patients with FE-CB phenotype. No significant between-group difference was observed with respect to BMI (MD-0.14, 95% CI -0.70–0.42, P=0.62, I2=75%). Conclusion: COPD patients with the FE-CB phenotype had poorer pulmonary function and higher CAT score, the quantity of cigarettes smoked (pack-years), frequency of acute exacerbations, and mMRC scores than those with the NE phenotype.


Author(s):  
Rostam Yazdani ◽  
Hamid Marefati ◽  
Armita Shahesmaeili ◽  
Alireza Bagheri ◽  
Ahmad Alinaghi Langari ◽  
...  

Background: Chronic obstructive pulmonary disease (COPD) is a major health issue worldwide. Introduction: This study aimed to evaluate the effect of aerobic exercises at steep surfaces on Apo A1 and Apo B serum levels and their ratio in COPD patients. Methods: This interventional study was undertaken on 16 COPD patients. The sample was selected by using the random sampling method. Patients were randomly divided into 2 groups of 8 members: uphill and downhill. Spirometry was conducted prior to the exercises and pulmonary volumes were measured. Aerobic exercises (stationary bicycle and treadmill) were started 3 times a week for 8 weeks. The duration of exercises in each session was determined based on the patients’ ability (30-40 min). In the first and second group, exercises were performed on sloped surfaces that were downwards and upwards at a 10-degree angle, respectively. Blood samples were taken from the patients before and after the 8 weeks. Apo A1 and Apo B serum levels and Apo A1 to Apo B ratio were measured. Data were analyzed by SPSS software. P<0.05 was considered statistically significant. Results: ApoA1/Apo B ratio in the uphill group before and after the intervention was 1.43±0.21 and 1.53±0.24 mg/dL, respectively, with P-value=0.36. In the downhill group, this value was 1.27±0.17 and 1.30±0.18, respectively, with a P-value=0.032. Conclusion: In light of the results of the present study, incorporating downhill exercises in COPD patients' rehabilitation program can help improve pulmonary function and prevent atherosclerotic events.


2015 ◽  
Vol 93 (6) ◽  
pp. 541-547 ◽  
Author(s):  
Marwa F. Abd El-Fatah ◽  
Mohamed A. Ghazy ◽  
Mohamed S. Mostafa ◽  
May M. El-Attar ◽  
Ahmed Osman

Chronic obstructive pulmonary disease (COPD) is a complex immunological disease with multiple pathological features that is primarily induced by smoking together with additional genetic risk factors. COPD is frequently underdiagnosed; forced expiratory volume in the first second (FEV1) is considered to be the main diagnostic measure for COPD, yet it is insufficiently sensitive to monitor disease progression. Biomarkers capable of monitoring COPD progression and severity are needed. In this report, we evaluated matrix metalloproteinase-9 (MMP-9) as an early marker for the detection and staging of COPD, by assessing the mRNA levels of MMP-9 in peripheral blood samples collected from 22 COPD patients, 6 asymptomatic smokers, and 5 healthy controls. Our results demonstrate that the mRNA levels of MMP-9 increased more than two-fold in severe COPD relative to non-COPD smokers or moderate COPD groups. Moreover, in the very severe COPD group, MMP-9 mRNA levels showed a 4-fold increase relative to the non-COPD smokers or the moderate COPD groups, while there was a mild increase (∼40%) when compared to the severe COPD group. Taken together, our results suggest that MMP-9 serves as a biomarker for the grade and severity of COPD.


Author(s):  
. Ranjana ◽  
Mishra Indira Sushil ◽  
Rajiv Ranjan Prasad

Introduction: The antioxidants requirement depend on one’s exposure to endogenous and exogenous reactive oxygen species.Cigarette smoking leads to increased exposure to reactive oxygen species,hence they require more antioxidant nutrients In this study, we aimed to study the serum levels of malondialdehyde (MDA) as a marker of oxidative stress and pulmonary function tests (PFT) and to study if there is any correlation between PFTand MDA levels in, smokers,chronic obstructive pulmonary disease (COPD) patients. Aim: To compare the pulmonary function tests (PFT) and serum malondialdehyde (MDA) level in smokers, chronic obstructive pulmonary disease (COPD) patients with non-smoker controls. Methods and Materials: N=30, 35-50 years age group smokers, COPD patients were enrolled as cases.N=30 age and sex matched were enrolled as control group. Serum MDA and PFT parameters like forced vital capacity (FVC), forced expiratory volume in first second (FEV1), FEV1/FVC ratio, Peak expiratory flow rate (PEFR) were measured. Result: PFT parameters like forced vital capacity (FVC), forced expiratory volume in first second (FEV1), FEV1/FVC ratio, peak expiratory flow rate(PEFR) were decreased and found statistically significant in smokers, COPD group.MDA level were increase and found statistically highly significant in smokers, COPD group. Conclusion: MDA is negatively correlated with FEV1% predicted, FEV1/FVC % predicted ratio and FVC in smokers, COPD patients


2020 ◽  
Author(s):  
Elise Guiedem ◽  
Eric Walter Pefura-Yone ◽  
George Mondinde Ikomey ◽  
Céline Nkenfou ◽  
Martha Mesembe ◽  
...  

Abstract Background: Previous studies have shown that tuberculosis (TB) is a risk factor for chronic airflow limitation. Chronic obstructive pulmonary disease (COPD) is recognized as the result of chronic inflammation, usually related to noxious particles. Post-TB airflow obstruction and tobacco-related COPD have the same functional pathway characterized by persistent airflow limitation. We sought to compare the profile of 29 cytokines in the sputum of subjects with post-TB airflow obstruction and those with COPD related to tobacco.Results: The forced expiratory volume in the first second (FEV1) and forced expiratory volume/forced vital capacity (FEV/FVC) ratio were lower in the COPD patients with the history of smoking compared to the post-TB airflow obstruction subgroup. The stages of the disease were more advanced in COPD / tobacco patients. Among the cytokines, IL-1α, IL-1β, MIP-1β, sCD40L and VEGF levels were higher in COPD patients, compared to the controls with p values ​​of 0.003, 0.0001, 0.03, 0.0001 and 0.02 respectively. When the two COPD subgroups were compared, IL-1α, IL-6, TNF-α and IL-8 levels were higher in the COPD patients with the history of tobacco compared to the COPD patients with the history of TB with p-values ​​of 0.031, 0.05, 0.021 and 0.016, respectively. Conclusion: COPD related to tobacco is more severe than post-TB airflow obstruction. The pathogenesis of post-TB airflow obstruction appears to involve the cytokines IL-1RA, IL-1α, IL-1β, IL-17, GRO and sCD40L, while COPD related to tobacco involves more cytokines.


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