Biomarkers in COPD

Abstract

Chronic Obstructive Pulmonary Disease is characterized by an abnormal inflammatory response of the lungs to noxious particles and gases, caused primarily by cigarette smoking. Although COPD affects the lung, it also produces significant systemic consequences. Inflammation, proteases-antiproteases imbalance, oxidative stress, tissue damage and tissue repair, apoptosis and several genes seem to be involved in the pathogenesis of the disease. The cellular and molecular events underlying COPD pathogenesis are driven by multifunctional molecules including enzymes, cytokines, chemokines, growth factors, lipid mediators and their respective receptors. A large number of biomarkers evaluated in COPD, showed a high degree of redundancy. Nevertheless, current understanding of the pathobiology of COPD suggests a number of biomarkers as potential candidates. The development of relevant markers of lung damage, pulmonary inflammation, and systemic disease will be essential to our further understanding of the natural history of COPD and the discovery of new, effective treatments for its progression. This review summarizes recent findings, on potential pulmonary biomarkers in the induced sputum, the exhaled air condensate, the peripheral blood, the urine, the bronchoalveolar lavage fluid, and in selective cases, in bronchial biopsies.

Inflammatory response of lung macrophages and epithelial cells to tobacco smoke: a literature review of ex vivo investigations

“…Today, chronic inflammation is viewed as a biomarker that often precedes tumor formation and, therefore, may prove useful in cancer detection [1][2][3][4][5][6][7][8][9][10][11][12][13]. Moreover, biomarkers of inflammation have been used recently in studies assessing the prevention of various diseases [1,[14][15][16][17].…”

“…One of the primary clinically defined events of smoke-associated inflammation is the influx of macrophages (MU) [2][3][4][5][6][7][8]10]. Notable is that the lung of a long-term smoker contains a large and unique population of ''pigmented'' MU that is readily seen in conventional white-light examinations of stained wax block sections [27,28].…”

Identification of Lipocalin and Apolipoprotein A1 as Biomarkers of Chronic Obstructive Pulmonary Disease

“…It is also hoped that some of these could speed up drug discovery by serving as surrogate markers that respond to novel drugs within a shorter time span than spirometric measurements of lung function, currently the main clinical outcome in drug trials. Although studies in patients with COPD have identified several biomarkers, most of these have not been fully validated and their prognostic value remains unclear (6,(11)(12)(13)(14)(15). Many of the markers have been identified in blood and, although it is recognized that there are nonpulmonary consequences of COPD, some of which can be viewed as systemic (16,17), biomarkers measured and/or generated in the lungs are likely to be most informative.…”

Natural Histories of Chronic Obstructive Pulmonary Disease

“…A large number of biomarkers have been evaluated, to some degree, in these contexts. None have yet been validated as effective clinical tools (60)(61)(62)(63). As the study of these makers advances, however, it will be important to define their ''natural histories'' in the context of COPD, both as they relate to ''stable'' disease and to acute exacerbations.…”