C-reactive protein in patients with COPD, control smokers and non-smokers

Abstract

Background: Patients with chronic obstructive pulmonary disease (COPD) have raised serum levels of C reactive protein (CRP). This may be related directly to COPD and its associated systemic inflammation or secondary to other factors such as concomitant ischaemic heart disease (IHD) or smoking status. The aim of this study was to evaluate IHD and smoking as potential causes of raised CRP levels in COPD and to test the association between inhaled corticosteroid (ICS) use and serum CRP levels. Methods: Cross sectional analyses comparing cohorts of 88 patients with COPD, 33 smokers (S), and 38 non-smoker (NS) controls were performed. Clinical assessments included a complete medical history, pulmonary function, 6 minute walk test (6MWT), cardiopulmonary exercise test, and high sensitivity serum CRP measurements. Results: Serum CRP levels were significantly higher in patients with COPD (5.03 (1.51) mg/l) than in controls (adjusted odds ratio 9.51; 95% confidence interval 2.97 to 30.45) but were similar in the two control groups (S: 2.02 (1.04) mg/l; NS: 2.24 (1.04) mg/l). There was no clinical or exercise evidence of unstable IHD in any of the subjects. CRP levels were lower in COPD patients treated with ICS than in those not treated (3.7 (3.0) mg/l v 6.3 (3.6) mg/l); this association was confirmed in an adjusted regression model (p,0.05). Conclusion: CRP levels are raised in COPD patients without clinically relevant IHD and independent of cigarette smoking, and reduced in patients with COPD using ICS. CRP may be a systemic marker of the inflammatory process that occurs in patients with COPD.

Association of oxidative stress markers and C-reactive protein with multidimensional indexes in COPD

“…23 Therefore, comparisons of our results with the literature are limited, as other studies used patients with more severe COPD. [24][25][26][27] The values of the oxidative stress markers from the severe and very severe groups in our study were always higher than those of the patients with mild or moderate COPD, which is in keeping with what has been published. 28 Studies assessing other oxidative stress markers, such as 4-hydroxy-2-nonenal (4-HNE) in airways and alveolar epithelial cells, 28 and an analysis of condensed air 25 also found a negative correlation between these markers and the severity of the disease assessed through FEV 1 as we found in our study (r ¼ -0.39; p ¼ 0.01; Figure 1).…”

“…The negative correlation between CRP and the distance walked during the 6MWT found by us is similar to the findings of Pinto-Plata et al 27 and Torres et al 24 The fact that the correlation was stronger between CRP and the BODE index than a multidimensional index that does not take into account the 6MWT 10 seems to demonstrate that CRP is actually well associated with physical capacity. It was recently shown that physical activity reduces the risk of having high levels of circulating TNF-a and CRP.…”

Evaluation of Lipid Parameters , Liver Function Test , CRP and MDA (as a marker of lipid peroxidation) in Chronic Cigarette Smokers

“…They also showed a linear association of CRP with the number of cigarettes smoked per day [29]. A study by PintoPlata et al also supported our study [30].…”

Leukocyte myeloperoxidase activity and serum CRP levels as predictive markers of inflammatory disorders amongst Passive smokers

“…However, another study conducted in people of Japanese ethnicity (the Iwate Kenpoku Cohort study) failed to identify any significant relationship between serum CRP concentration and the number of cigarettes smoked per day (31) . MONICA study from Germany, reported significantly high serum CRP concentrations in male smokers with no significant difference in women smokers 32 . In contrast, another study examining CRP levels in patients with moderate to severe COPD reported that, although there was a significant difference in CRP levels in the COPD patients, there was no difference in CRP status between smokers and non-smokers 33 .…”