Inflammatory Biomarkers in Chronic Obstructive Pulmonary Disease

Abstract

Background. The role of systemic inflammation in patients with chronic obstructive pulmonary disease (COPD) remains to be defined. This prospective, observational study was designed to analyse the hypothesis that inflammatory biomarkers in stable COPD can be used as measure of disease severity and risk of exacerbation.Methods. We conducted a case-control study in a tertiary care, university-affiliated hospital. COPD patients and controls were matched for sex and age in a 1:1 matching ratio. All COPD patients included in the study had to be clinically stable without a history of exacerbation in the last four weeks and should not have been on oral steroid therapy (in the last 4 weeks) or on long-term oxygen therapy. We included only those patients who had quit smoking. Fibrinogen levels and pulmonary function tests were performed in both the groups. Results.The mean plasma fibrinogen level, total leucocyte count, neutrophil count and erythrocyte sedimentation rate in patients with COPD were significantly higher than that of controls (p=0.001). The study also showed a significant association between plasma fibrinogen levels with severity of COPD (p<0.001) and number of exacerbations in the previous year (p=0.001).Conclusions. Patients with COPD had significantly higher levels of inflammatory markers than healthy individuals. Plasma fibrinogen level was significantly higher in higher Global Initiative for Chronic Obstructive Lung Disease GOLD class and with more number of prior exacerbations. Hence, fibrinogen may act as a surrogate marker of disease activity in patients with COPD and may help to risk stratify COPD patients for future exacerbations.