Background: Acute exacerbation of COPD (AECOPD) is a decrease in respiratory conditions compared with regular conditions that require additional treatment, increase risk of hospitalization or demand intensive care unit. The neutrophil-to-lymphocyte ratio (NLR) describes the balance between the severity of inflammation and the immune system and is considered as an important systemic inflammatory marker. Length of hospital stay (LHS) is important in predicting the severity of AECOPD, in which longer LHS indicates greater severity of AECOPD. Secretome has been shown to have the ability to exert immunomodulatory effects, reduce lung injury and inflammation in several models of lung inflammation and immune-mediated lung disease. This study aimed to assess the differences between NLR and LHS in AECOPD patients who received a secretome and those who did not.Methods: This study involved 30 AECOPD patients whom assigned into two groups. Secretome and standard therapy were administered in the treatment group, whilst the control group only received the standard therapy. Statistical analysis used different test, the unpaired group difference test using Mann Whitney and the independent test, the paired group difference test using Wilcoxon rank test and Pair test. Result is significant if the P<0.05.Results: NLR value in the treatment group experienced a lower increase than the control group, yet statistically insignificant (P=0,187). Secretome decreased the LHS in AECOPD patients, and statistically significant with (P=0,028). Conclusion: Administration of secretome led to a lower increase in NLR value and decreased LHS AECOPD patients.

Acute exacerbation chronic obstructive pulmonary disease (AECOPD) is associated with significant poor survival. Mesenchymal stem cells (MSC) therapy has been a promising treatment for COPD; therefore, it has the potential to be an additional therapy for AECOPD. Its potential is associated with its secretome since it has anti-inflammatory and immunomodulator activities. The aim of this study was to determine the effect of the secretome as an adjuvant therapy in reducing the levels of interleukin-6 (IL-6), tumor necrosis factor-α (TNF-α), procalcitonin, and the length of stay in AECOPD patients. A clinical control trial study was conducted among 28 moderate and severe AECOPD patients who were hospitalized from January to February 2023. The control group (n=14) received standard therapy of AECOPD while the treatment group (n=14) received standard therapy plus secretome 1 ml twice daily for three days. The levels of IL-6, TNF-α, and procalcitonin were measured at admission and on the fourth day of treatment. The length of stay was calculated from the time the patient was admitted until the patient was discharged from hospital. The data were compared using a paired Student t-test, chi-squared test and Mann-Whitney test as appropriate. In the treatment group, the levels of IL-6, TNF-α and procalcitonin after the treatment reduced 13.09 pg/mL, 5.00 pg/mL and 751.26 pg/mL, respectively compared to pre-treatment. In contrast, the levels of IL-6, TNF-α and procalcitonin increased 48.56 pg/mL, 44.48 pg/mL and 346.96 pg/mL, respectively after four days of treatment. There was a significant reduction of IL-6, TNF-α and procalcitonin in treatment group compared to the control group with p=0.022, p=0.009 and p=0.001, respectively. However, there was no significant reduction of the length of stay (p=0.072). In conclusion, administration of secretome to AECOPD patients could reduce the levels of IL-6, TNF-α and procalcitonin.