Sputum procalcitonin – a potential biomarker in stable bronchiectasis
Introduction/AimSputum procalcitonin has been demonstrated to be elevated in exacerbations of bronchiectasis. The primary aim was to investigate whether sputum procalcitonin levels were higher in patients with stable bronchiectasis compared with healthy-controls. We also assessed differences in procalcitonin levels in spontaneously expectorated and induced sputum samples and their repeatability one week later.MethodsParticipants included were aged over 18 years and had either radiologically confirmed bronchiectasis or were healthy-controls. Patients with bronchiectasis were clinically stable for at least six weeks and had both spontaneous and induced sputum collected at visit one and again, seven days later. Only induced sputum samples were collected from healthy-controls during visit one. Sputum procalcitonin concentrations in sputum were measured.ResultsThirty patients with bronchiectasis and 15 healthy-controls were enrolled in this observational study. In the pooled data from visit 1 and 2, the geometric mean procalcitonin level in induced sputum was significantly higher in the bronchiectasis group than in the healthy-control group (1.5 ng·mL−1 [95%CI 1.0–2.1] versus 0.4 ng·mL−1 [95%CI 0.2–0.9], mean ratio: 3.6 [95% CI 1.5–8.6], p=0.006). Mean procalcitonin level was higher in spontaneous sputum than in induced sputum at visit 1 (1.8 ng·mL−1 [95%CI 1.2–2.7] versus 1.1 ng·mL−1 [95%CI 0.7–1.8]) and visit 2 (1.5 ng·mL−1 [95%CI 1.0–2.5] versus 1.2 ng·mL−1 [95%CI 0.8–1.6], p-value=0.001). Repeating spontaneous and induced sputum procalcitonin levels one week later produced similar concentrations (p-value=0.29; intraclass correlation co-efficient (ICC)=0.76 and p-value=0.72; ICC=0.70 respectively).ConclusionSputum procalcitonin is increased in patients with stable bronchiectasis and has potential as a biomarker of airway inflammation and infection in bronchiectasis.