scholarly journals The Combination of Hemogram Indexes to Predict Exacerbation in Stable Chronic Obstructive Pulmonary Disease

2020 ◽  
Vol 7 ◽  
Author(s):  
Xuanqi Liu ◽  
Haiyan Ge ◽  
Xiumin Feng ◽  
Jingqing Hang ◽  
Fengying Zhang ◽  
...  
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Pulmonary Disease ◽  
Calibration Curve ◽  
Roc Curve ◽  
Chronic Obstructive ◽  
Obstructive Pulmonary Disease ◽  
Neutrophil Lymphocyte Ratio ◽  
Lymphocyte Ratio ◽  
Copd Patients ◽  
Exacerbation Of Copd

Background: Chronic obstructive pulmonary disease (COPD) is characterized by pulmonary and systemic inflammatory processes, and exacerbation of COPD represents a critical moment in the progression of COPD. Several biomarkers of inflammation have been proposed to have a predictive function in acute exacerbation. However, their use is still limited in routine clinical practice. The purpose of our study is to explore the prognostic efficacy of novel inflammatory hemogram indexes in the exacerbation among stable COPD patients.Method: A total of 275 stable COPD patients from the Shanghai COPD Investigation Comorbidity Program were analyzed in our study. Blood examinations, especially ratio indexes like platelet–lymphocyte ratio (PLR), platelet × neutrophil/lymphocyte ratio [systemic immune-inflammation index (SII)], and monocyte × neutrophil/lymphocyte ratio [systemic inflammation response index (SIRI)], lung function test, CT scans, and questionnaires were performed at baseline and routine follow-ups. Clinical characteristics and information of exacerbations were collected every 6 months. The relationship between hemogram indexes and diverse degrees of exacerbation was assessed by logistic regression. The receiver operating characteristic (ROC) curve and area under the curve (AUC) were used to evaluate the ability of hemogram indexes to predict exacerbation of COPD. Furthermore, the discrimination and accuracy of combined indexes were measured by ROC and calibration curve.Result: There was a significant positive correlation between PLR levels and total exacerbation of COPD patients in a stable stage in a year. Also, the predictive ability of PLR exceeded any other ratio indexes, with an AUC of 0.66. SII and SIRI ranked second only to PLR, with an AUC of 0.64. When combining PLR with other indexes (sex, COPD year, and St. George's Respiratory Questionnaire scores), they were considered as the most suitable panel of index to predict total exacerbation. Based on the result of the ROC curve and calibration curve, the combination shows optimal discrimination and accuracy to predict exacerbation events in COPD patients.Conclusion: The hemogram indexes PLR, SII, and SIRI were associated with COPD exacerbation. Moreover, the prediction capacity of exacerbation was significantly elevated after combining inflammatory hemogram index PLR with other indexes, which will make it a promisingly simple and effective marker to predict exacerbation in patients with stable COPD.

scholarly journals Serum Procalcitonin Guided Antibiotic Therapy in Patients with Acute Exacerbation of Chronic Obstructive Pulmonary Disease

2015 ◽  
Vol 3 (2) ◽  
pp. 67-70
Author(s):  
Rawshan Arra Khanam ◽  
Md Ashraful Haque ◽  
Mohammad Omar Faruq
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Antibiotic Therapy ◽  
Pulmonary Disease ◽  
Hospital Admissions ◽  
Respiratory Infections ◽  
Chronic Obstructive ◽  
Acute Phase Reactants ◽  
Obstructive Pulmonary Disease ◽  
Copd Patients ◽  
Exacerbation Of Copd

Chronic obstructive pulmonary disease (COPD) is a preventable and treatable, but progressive disease. Hospital admissions of patients with COPD are frequently due to acute exacerbations of COPD (AECOPD). AECOPD are very common, affecting about 20% of COPD patients. The bacterial infection plays an important role in the exacerbation of COPD patients. In addition, recent studies using molecular diagnostics indicate that a substantial proportion of AECOPD are associated with viral infection. Accurate methods to differentiate viral and bacterial respiratory infections to allow targeted antibiotic therapy would be beneficial. Acute phase reactants are capable of demonstrating the inflammation; however, they cannot be employed to make a difference between bacterial and nonbacterial causes of the inflammation. Recently, measurement of procalcitonin (PCT) levels appears to be useful in order to minimize this problem.Bangladesh Crit Care J September 2015; 3 (2): 67-70

scholarly journals Host-Pathogen Interaction during Pneumococcal Infection in Patients with Chronic Obstructive Pulmonary Disease

2004 ◽  
Vol 72 (2) ◽  
pp. 818-823 ◽  
Author(s):  
Debby Bogaert ◽  
Paul van der Valk ◽  
Reshmi Ramdin ◽  
Marcel Sluijter ◽  
Evelyn Monninkhof ◽  
...  
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Pulmonary Disease ◽  
Acute Exacerbation ◽  
Pneumococcal Infection ◽  
Chronic Obstructive ◽  
Obstructive Pulmonary Disease ◽  
Copd Patients ◽  
Antibody Titers ◽  
Pneumococcal Colonization ◽  
Exacerbation Of Copd

ABSTRACT Acute exacerbation is a frequent complication of chronic obstructive pulmonary disease (COPD). Recent studies suggested a role for bacteria such as Streptococcus pneumoniae in the development of acute exacerbation. For this study, we investigated the following in COPD patients: (i) the epidemiology of pneumococcal colonization and infection, (ii) the effect of pneumococcal colonization on the development of exacerbation, and (iii) the immunological response against S. pneumoniae. We cultured sputa of 269 COPD patients during a stable state and during exacerbation of COPD and characterized 115 pneumococcal isolates by use of serotyping. Moreover, we studied serum immunoglobulin G (IgG) antibody titers, antibody avidities, and functional antibody titers against the seven conjugate vaccine serotypes in these patients. Colonization with only pneumococci (monocultures) increased the risk of exacerbation, with a hazard ratio of 2.93 (95% confidence interval, 1.41 to 6.07). The most prevalent pneumococcal serotypes found were serotypes 19F, 3, 14, 9L/N/V, 23A/B, and 11. We calculated the theoretical coverage for the 7- and 11-valent pneumococcal vaccines to be 60 and 73%, respectively. All patients had detectable IgG levels against the seven conjugate vaccine serotypes. These antibody titers were significantly lower than those in vaccinated healthy adults. Finally, on average, a 2.5-fold rise in serotype-specific and functional antibodies in S. pneumoniae-positive sputum cultures was observed during exacerbation. Our data indicate that pneumococcal colonization in COPD patients is frequently caused by vaccine serotype strains. Moreover, pneumococcal colonization is a risk factor for exacerbation of COPD. Finally, our findings demonstrate that COPD patients are able to mount a significant immune response to pneumococcal infection. COPD patients may therefore benefit from pneumococcal vaccination.

scholarly journals Associations Between Sputum Torque Teno Virus Load and Lung Function and Disease Severity in Patients With Chronic Obstructive Pulmonary Disease

2021 ◽  
Vol 8 ◽  
Author(s):  
Yu Xie ◽  
Qing Xue ◽  
Weike Jiao ◽  
Jianhui Wu ◽  
Yan Yu ◽  
...  
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Viral Load ◽  
Lung Function ◽  
Pulmonary Disease ◽  
Disease Severity ◽  
Torque Teno Virus ◽  
Chronic Obstructive ◽  
Obstructive Pulmonary Disease ◽  
Copd Patients ◽  
Exacerbation Of Copd

Purpose: Viral load of Torque Teno virus (TTV) is elevated in immunosuppressed patients. The weakened immune response is typical in chronic obstructive pulmonary disease (COPD) patients. However, the relationship between TTV and COPD is still unknown.Patients and Methods: We enrolled 91 patients admitted to hospitals with acute exacerbation of COPD (AECOPD) between January 2017 and August 2017 (ClinicalTrials.gov ID, NCT03236480). Sputum samples were gathered during hospitalization and the 120-day follow-up. TTV distribution and genogroups were assessed, and the associations between viral loads and clinical parameters were analyzed.Results: TTV DNA was detected in 95.6% of COPD patients, and the viral load was nearly invariable at the stable and exacerbation states. Most TTV DNA-positive patients carried four distinct genotypes. Sputum load of TTV was positively associated with RV/TLC (r = 0.378, p = 0.030), and negatively correlated with FEV1/pre and FEV1/FVC (r = −0.484, −0.432, p = 0.011, 0.024, respectively). Neutral correlation between the TTV DNA load and COPD assessment test (CAT) scores (r = 0.258, p = 0.018) was observed.Conclusion: Sputum loads of TTV DNA could be a novel indicator for lung function and disease severity assessment in COPD patients.

scholarly journals Influence of disease severity, smoking status and therapy regimes on leukocyte subsets and their ratios in stable chronic obstructive pulmonary disease

2020 ◽  
Author(s):  
Iva Hlapčić ◽  
Andrea Vukić Dugac ◽  
Sanja Popović-Grle ◽  
Ivona Markelić ◽  
Ivana Rako ◽  
...  
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Pulmonary Disease ◽  
Disease Severity ◽  
Blood Cells ◽  
Smoking Status ◽  
White Blood Cells ◽  
Chronic Obstructive ◽  
Obstructive Pulmonary Disease ◽  
Lymphocyte Ratio ◽  
Copd Patients

IntroductionBlood cells are involved in systemic inflammation in chronic obstructive pulmonary disease (COPD). We aimed to assess differences in leukocyte subsets and their ratios between COPD patients and healthy individuals as well as their association with disease severity, smoking status and therapy in COPD.Material and methodsOne hundred and nine patients in the stable phase of COPD and 95 controls participated in the study. After blood sampling, white blood cells (WBC), neutrophils (NEUTRO), monocytes (MO), lymphocytes (LY) and basophils (BA) were determined on a Sysmex XN-1000 analyser, and ratios were calculated afterwards.ResultsWhite blood cells, NEUTRO, MO and BA were higher in COPD patients than in controls. Also, COPD patients had increased neutrophil to lymphocyte ratio (NLR), derived NLR (dNLR), monocyte to lymphocyte ratio (MLR), basophil to lymphocyte ratio (BLR), basophil to monocyte ratio (BMR) and monocyte/granulocyte to lymphocyte ratio (M/GLR). Smoking has an impact on leukocyte counts, with BA, BLR and BMR being higher in COPD smokers vs. ex-smokers. Patients with very severe COPD were distinguished from moderate COPD by NLR, dNLR and M/GLR. In addition, those parameters were associated with lung function and dyspnoea, and NLR and dNLR also with multicomponent COPD indices BODCAT and DOSE. Great potential of dNLR, NLR and M/GLR in identifying COPD patients was observed regarding their odds ratios (OR) of 5.07, 2.86, 2.60, respectively (p < 0.001). Common COPD therapy did not affect any of the parameters investigated.ConclusionsLeukocyte subsets and their ratios could be implemented in COPD assessment, especially in evaluating disease severity and prediction.

scholarly journals Correlations between neutrophil to lymphocyte ratio, blood eosinophils and clinical characteristics in chronic obstructive pulmonary disease

2019 ◽  
Author(s):  
Ana Florica Chis ◽  
Carmen Monica Pop
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Pulmonary Disease ◽  
Neutrophil To Lymphocyte Ratio ◽  
Smoking History ◽  
Chronic Obstructive ◽  
Obstructive Pulmonary Disease ◽  
Lymphocyte Ratio ◽  
Bode Index ◽  
Copd Patients ◽  
Blood Eosinophils

Background and aims. Chronic obstructive pulmonary disease (COPD) is currently the third leading cause of death worldwide, with increasing mortality and morbidity. The neutrophil to lymphocyte ratio (NLR) and blood eosinophils level (EOS) represent  biomarkers of inflammation in various diseases, with current research in the field of COPD. The aim of this study was to determine correlations of NLR and EOS with certain characteristics of COPD in a group of patients without major comorbidities. Methods. We conducted an observational study on COPD patients admitted to the Clinical Hospital of Pneumology in Cluj-Napoca, Romania. The smoking history, body mass index (BMI), NLR, EOS, erythrocyte sedimentation rate (ESR), C-reactive protein (CRP) and the arterial partial pressure of oxygen (PaO2) were determined. Functional assessment consisted of spirometric and BODE index determinations. The duration of hospitalization was expressed as the length of stay (LOS). The patients were divided into 3 subgroups: active smokers (AS), former smokers (FS) and never smokers (NS). Results. No significant differences between AS and FS were found when age, airway obstruction, BODE index, PaO2, ESR and CRP were considered. The NLR was higher in AS versus FS (p=0.035), while EOS was lower in AS group (p=0.061). COPD patients with ≥300EOS/μL had lower CRP, ESR levels and NLR compared to those with eosinophilia˂300/ μL (p=0.020, p=0.009 and p=0.007, respectively). With a threshold of 3.5 for NLR, patients with lower NLR had lower CRP values (p=0.05). COPD patients with higher NLR had significant lower EOS levels (p=0.018). Overall, the NLR and EOS were not correlated with the investigated characteristics (p˃0.05), but intragroup analysis (based on smoking status) revealed correlations with ESR (p=0.0001), CRP (p=0.053), BODE index (p=0.029) and LOS (p=0.042).             Conclusions. AS have higher NLR and lower EOS lelvels versus FS. COPD patients  with higher EOS level have lower CRP, ESR and NLR. In AS, EOS level is positively correlated with BODE index and negatively correlated with NLR.

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