Biomarkers of Systemic Inflammation in Stable and Exacerbation Phases of COPD

Abstract

Apart from the deleterious effects on the lungs, chronic obstructive pulmonary disease (COPD) should be considered a complex, systemic disease involving several organs and systems. The nature and course of systemic inflammation in COPD is important since there is a potential for anti-inflammatory therapy. The objective of the current study was to assess biomarkers of systemic inflammation in stable and exacerbation phases of COPD patients as compared to healthy controls. We also investigated the course of these biomarkers after COPD exacerbation to evaluate their usefulness for disease monitoring. Eighty-three stable patients with moderate to very severe COPD, 20 patients in exacerbation phase, and 30 subjects with normal pulmonary function were included. Serum tumor necrosis factor-alpha (TNF-alpha), interleukin-6 (IL-6), and nitric oxide (NO) levels were measured once in stable COPD patients and controls and three times in the COPD exacerbation group during follow-up. TNF-alpha and IL-6 levels were higher than in controls in both stable and exacerbation groups. Although NO was not higher in the stable COPD group than in controls, it was higher in the exacerbation group. In follow-up after the exacerbation period, significant alteration was not detected in cytokine or NO levels compared to admission. Raised serum levels of TNF-alpha and IL-6 support their use as biomarkers of the systemic inflammatory response in stable COPD patients. However, the circulating biomarkers we have studied are not found to be useful either as indicators of COPD exacerbation or for monitoring recovery after exacerbation.

An Official American Thoracic Society/European Respiratory Society Statement: Update on Limb Muscle Dysfunction in Chronic Obstructive Pulmonary Disease

“…Conflictual or negative results regarding apoptosis and macroautophagy in the muscles of COPD demand further studies to explore the role of these mechanisms (102,189,236). Although increased inflammatory response is seen during exacerbated COPD (328,329), similar observation is controversial in stable patients (201,232,(330)(331)(332). One relevant negative observation is the lack of evidence of muscle inflammation in this human model of muscle atrophy (332,333).…”

“…In COPD, systemic (226) and local (219, 220) oxidative stress have been reported. Acute bouts of exercise (224,226) as well as acute exacerbation (329,337) increase the level of oxidative stress. Direct oxidative stress exposure (338) or indirect production of ROS through inflammatory response (339,340) induces proteolysis and increases expression of UbP components.…”

Clinical evaluation of the levels of 12 cytokines in serum/plasma under various storage conditions using evidence biochip arrays

“…IL-10 levels are associated with early treatment failure of advanced stage Hodgkin's lymphoma and are independent of current known clinical factors (4). Serum TNFα, IL-6 and nitric oxide (NO) levels have also been identified as biomarkers during systemic inflammatory response in chronic obstructive pulmonary disease (COPD) patients and, to a lesser degree, in COPD exacerbation or monitoring recovery following exacerbation (5). Elevated levels of TNFα and IL-6 have also been reported in coronary artery disease (CAD) and systolic heart failure (6) and are associated with the immunoinflammatory activation process.…”

Pulmonary Hypertension in Chronic Obstructive Pulmonary Disease and Pulmonary Fibrosis: Prevalence and Hemodynamic Differences in Lung Transplant Recipients at Transplant Center's Referral Time

“…COPD is defined in terms of airflow obstruction that results from an inflammatory process affecting the airways and lung parenchyma. Different inflammatory mediators can have local and systemic activities and clinical consequences [3,4]. Changes in pulmonary vessels represent an important component of the disease.…”