https://doi.org/10.4081/monaldi.2024.2955
Gaining insights into chronic obstructive pulmonary disease exacerbation through emerging biomarkers and the chronic obstructive pulmonary disease assessment test score
Submitted: February 13, 2024
Accepted: February 26, 2024
Published: March 14, 2024
Accepted: February 26, 2024
Abstract Views: 561
PDF_EARLY VIEW: 286
Publisher's note
All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.
All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.
Authors
Chronic obstructive pulmonary disease (COPD), a leading cause of mortality and morbidity, presents significant challenges, particularly with exacerbations, which drastically impact patients' health and healthcare costs. The Global Initiative for Chronic Obstructive Lung Disease guidelines recommend comprehensive assessments beyond spirometry, with the COPD assessment test (CAT) emerging as a pivotal tool. Despite its utility, the relationship between CAT scores and specific biomarkers during exacerbations remains unclear. Hence, this study aims to assess the correlation between the CAT score and specific circulating biomarkers. A cross-sectional study from August 2023 to January 2024 included 59 COPD patients with exacerbations who underwent pulmonary function tests and completed the CAT score assessment. The CAT score cut-off point was set at 20, where a CAT score <20 indicated a low impact on health status and a CAT score ≥20 indicated a high impact on health status. On the same day, measurements of neutrophils, leukocytes, eosinophils, C-reactive protein, and procalcitonin were conducted. Patients with CAT scores ≥20 had significantly higher levels of neutrophils (p=0.001), leukocytes (p=0.006), procalcitonin (p=0.010), and forced expiratory volume in the first second/forced vital capacity (p=0.002), but lower eosinophil levels (p=0.025). A positive correlation existed between total CAT score and neutrophils (p=0.001), leukocytes (p=0.000), and procalcitonin (p=0.010), while eosinophil levels showed a negative correlation (p=0.025). The spirometry parameters showed no correlation with the total CAT score. This study highlights the link between CAT and key inflammatory biomarkers, supporting the use of blood biomarkers to identify COPD patients at risk of exacerbations.
Mannino DM, Buist AS. Global burden of COPD: risk factors, prevalence, and future trends. Lancet 2007;370:765-73.
DOI: https://doi.org/10.1016/S0140-6736(07)61380-4
Salvi S. Letter from India. Respirology 2018;23:1074-5.
DOI: https://doi.org/10.1111/resp.13369
Salvi S, Kumar GA, Dhaliwal RS, et al. The burden of chronic respiratory diseases and their heterogeneity across the states of India: the Global Burden of Disease Study 1990-2016. Lancet Glob Health 2018;6:e1363-74.
DOI: https://doi.org/10.1016/S2214-109X(18)30409-1
Global Initiative for Chronic Obstructive Lung Disease. Global strategy for the diagnosis, management and prevention of chronic obstructive pulmonary disease. 2023. Available from: goldcopd.org/wp-content/uploads/2023/03/GOLD-2023-ver-1.3-17Feb2023_WMV.pdf.
Jones PW, Angusti AGN. Outcomes and markers in the assessment of chronic obstructive pulmonary disease. Eur Respir J 2006;27:822-32.
DOI: https://doi.org/10.1183/09031936.06.00145104
Jones PW. COPD assessment test - rationale, development, validation and performance. COPD 2013;10:269-71.
DOI: https://doi.org/10.3109/15412555.2013.776920
Agusti A, Sobradillo P, Celli B. Addressing the complexity of chronic obstructive pulmonary disease. Am J Respir Crit Care Med 2011;183:1129-37.
DOI: https://doi.org/10.1164/rccm.201009-1414PP
Lange P, Celli B, Agustí A, et al. Lung-function trajectories leading to chronic obstructive pulmonary disease. N Eng J Med 2015;373:111-22.
DOI: https://doi.org/10.1056/NEJMoa1411532
Hoenderdos K, Condliffe A. The neutrophil in chronic obstructive pulmonary disease. Am J Respir Cell Mol Biol 2013;48:531-9.
DOI: https://doi.org/10.1165/rcmb.2012-0492TR
Singh D, Kolsum U, Brightling CE, et al. Eosinophilic inflammation in COPD: prevalence and clinical characteristics. Eur Respir J 2014;44:1697-700.
DOI: https://doi.org/10.1183/09031936.00162414
Tashkin DP, Wechsler ME. Role of eosinophils in airway inflammation of chronic obstructive pulmonary disease. Int J Chron Obstruct Pulmon Dis 2018;13:335-49.
DOI: https://doi.org/10.2147/COPD.S152291
Vedel-Krogh S, Nielsen SF, Lange P, et al. Blood eosinophils and exacerbations in chronic obstructive pulmonary disease. The Copenhagen general population study. Am J Respir Crit Care Med 2016;193:965-74.
DOI: https://doi.org/10.1164/rccm.201509-1869OC
Chirouze C, Schuhmacher H, Rabaud C, et al. Low serum procalcitonin level accurately predicts the absence of bacteremia in adult patients with acute fever. Clin Infect Dis 2002;35:156-61.
DOI: https://doi.org/10.1086/341023
Christ-Crain M, Jaccard-Stolz D, Bingisser R, et al. Effect of procalcitonin-guided treatment on antibiotic use and outcome in lower respiratory tract infections: cluster-randomised, single-blinded intervention trial. Lancet 2004;363:600-7.
DOI: https://doi.org/10.1016/S0140-6736(04)15591-8
Corti C, Fally M, Fabricius-Bjerre A, et al. Point-of-care procalcitonin test to reduce antibiotic exposure in patients hospitalized with acute exacerbation of COPD. Int J Chron Obstruct Pulmon Dis 2016;11:1381-9.
DOI: https://doi.org/10.2147/COPD.S104051
Ghorani V, Boskabady MH, Khazdair MR, Kianmeher M. Experimental animal models for COPD: a methodological review. Tob Induc Dis 2017;15:25.
DOI: https://doi.org/10.1186/s12971-017-0130-2
Lonergan M, Dicker AJ, Crichton ML, et al. Blood neutrophil counts are associated with exacerbation frequency and mortality in COPD. Respir Res 2020;21:166.
DOI: https://doi.org/10.1186/s12931-020-01436-7
Koo HK, Kang HK, Song P, et al. Systemic white blood cell count as a biomarker associated with severity of chronic obstructive lung disease. Tuberc Respir Dis (Seoul) 2017;80:304-10.
DOI: https://doi.org/10.4046/trd.2017.80.3.304
Black S, Kushner I, Samols D. C-reactive Protein. J Biol Chem 2004;279:48487-90.
DOI: https://doi.org/10.1074/jbc.R400025200
Man SFP. C-reactive protein and mortality in mild to moderate chronic obstructive pulmonary disease. Thorax 2006;61:849-53.
DOI: https://doi.org/10.1136/thx.2006.059808
Thomsen M, Ingebrigtsen TS, Marott JL, et al. Inflammatory biomarkers and exacerbations in chronic obstructive pulmonary disease. JAMA 2013;309:2353-61.
DOI: https://doi.org/10.1001/jama.2013.5732
Pinto-Plata V, Casanova C, Müllerova H, et al. Inflammatory and repair serum biomarker pattern. Association to clinical outcomes in COPD. Respir Res 2012;13:71.
DOI: https://doi.org/10.1186/1465-9921-13-71
Abd-Elaziz AA, Alwahsh RA, Abd-Elaal GA, Tameem AAM. Correlation between CAT score, inflammatory markers and pulmonary function tests in patient with acute exacerbation of COPD. Egypt J Chest Dis Tuberc 2017;66:243-6.
DOI: https://doi.org/10.1016/j.ejcdt.2015.08.013
Chung KF. Cytokines in chronic obstructive pulmonary disease. Eur Respir J Suppl 2001;34:50s-9s.
DOI: https://doi.org/10.1183/09031936.01.00229701
Bienvenu J. Exploration of cytokines in inflammation in biological fluids. C R Seances Soc Biol Fil 1995;189:545-55. [Article in French].
Hurst JR, Vestbo J, Anzueto A, et al. Susceptibility to exacerbation in chronic obstructive pulmonary disease. N Engl J Med 2010;363:1128-38.
DOI: https://doi.org/10.1056/NEJMoa0909883
Celli BR, Locantore N, Yates J, et al. Inflammatory biomarkers improve clinical prediction of mortality in chronic obstructive pulmonary disease. Am J Respir Crit Care Med 2012;185:1065-72.
DOI: https://doi.org/10.1164/rccm.201110-1792OC
Cui Y, Zhan Z, Zeng Z, et al. Blood eosinophils and clinical outcomes in patients with acute exacerbation of chronic obstructive pulmonary disease: a propensity score matching analysis of real-world data in China. Front Med (Lausanne) 2021;8:653777.
DOI: https://doi.org/10.3389/fmed.2021.653777
Wu HX, Zhuo KQ, Cheng DY. Peripheral blood eosinophil as a biomarker in outcomes of acute exacerbation of chronic obstructive pulmonary disease. Int J Chron Obstruct Pulmon Dis 2019;14:3003-15.
DOI: https://doi.org/10.2147/COPD.S226783
Jabarkhil A, Moberg M, Janner J, et al. Elevated blood eosinophils in acute COPD exacerbations: better short- and long-term prognosis. Eur Clin Respir J 2020;7:1757274.
DOI: https://doi.org/10.1080/20018525.2020.1757274
Kim VL, Coombs NA, Staples KJ, et al. Impact and associations of eosinophilic inflammation in COPD: analysis of the AERIS cohort. Eur Respir J 2017;50:1700853.
DOI: https://doi.org/10.1183/13993003.00853-2017
Ko FWS, Chan KP, Ngai J, et al. Blood eosinophil count as a predictor of hospital length of stay in COPD exacerbations. Respirology 2020;25:259-66.
DOI: https://doi.org/10.1111/resp.13660
Chis AF, Pop CM. Correlations between neutrophil to lymphocyte ratio, blood eosinophils and clinical characteristics in chronic obstructive pulmonary disease. Med Pharm Rep 2020;93:169-74.
DOI: https://doi.org/10.15386/mpr-1412
Biju PG, Garg S, Wang W, et al. Procalcitonin as a predictive biomarker for total body irradiation-induced bacterial load and lethality in mice. Shock 2012;38:170-6.
DOI: https://doi.org/10.1097/SHK.0b013e31825b2db3
Borsi H, Nia E, Mal-Amir M, Raji H. Relationship between serum procalcitonin level and chronic obstructive pulmonary disease. J Family Med Prim Care 2019;8:738-40.
DOI: https://doi.org/10.4103/jfmpc.jfmpc_468_18
Pazarli AC, Koseoglu HI, Doruk S, et al. Procalcitonin: is it a predictor of noninvasive positive pressure ventilation necessity in acute chronic obstructive pulmonary disease exacerbation?. J Res Med Sci 2012;17:1047-51.
Bagheri MH, Hosseini SK, Mostafavi SH, Alavi SA. High-resolution CT in chronic pulmonary changes after mustard gas exposure. Acta radiol 2003;44:241-5.
DOI: https://doi.org/10.1080/j.1600-0455.2003.00073.x
Jones PW, Baveystock CM, Littlejohns P. Relationships between general health measured with the sickness impact profile and respiratory symptoms, physiological measures, and mood in patients with chronic airflow limitation. Am Rev Respir Dis 1989;140:1538-43.
DOI: https://doi.org/10.1164/ajrccm/140.6.1538
Jones P, Harding G, Wiklund I, Berry P, et al. Improving the process and outcome of care in COPD: development of a standardised assessment tool. Prim Care Respir J 2009;18:208-15.
DOI: https://doi.org/10.4104/pcrj.2009.00053
Ethics Approval
The study was approved by the Ethical Committee of KLE College of Pharmacy (IEC Reference Number: KLECOPH/IEC/2023-24/09).How to Cite
Hegde, Megha, Saurav Raj, Aishwarya S Pattanshetti, and Sanatkumar Bharamu Nyamagoud. 2024. “Gaining Insights into Chronic Obstructive Pulmonary Disease Exacerbation through Emerging Biomarkers and the Chronic Obstructive Pulmonary Disease Assessment Test Score”. Monaldi Archives for Chest Disease, March. https://doi.org/10.4081/monaldi.2024.2955.
Copyright (c) 2024 The Author(s)
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
PAGEPress has chosen to apply the Creative Commons Attribution NonCommercial 4.0 International License (CC BY-NC 4.0) to all manuscripts to be published.
Similar Articles
- Yaser Jenab, Marzieh Pourjafari, Maryam Sotoudeh, Masoumeh Lotfi-tokaldany, Nasrin Etesamifard, Shapour Shirani, Arash Jalali, Younes Nozari, Hamid-reza Poorhosseini, Comparing the effect of cardiac biomarkers on the outcome of normotensive patients with acute pulmonary embolism , Monaldi Archives for Chest Disease: Vol. 87 No. 1 (2017)
- Srishankar Bairy, Tarun Tiwari, Himanshu Mittal, Neeraj Gupta, Meghana M, Inhaled corticosteroids in asthma and chronic obstructive pulmonary disease combined phenotype: when to use and what to expect? , Monaldi Archives for Chest Disease: Early Access
- Amanda R. van Buul, Marise J. Kasteleyn, Vitalii Poberezhets, Tobias N. Bonten, Renée de Mutsert, Pieter S. Hiemstra, Saskia le Cessie, Frits R. Rosendaal, Niels H. Chavannes, Christian Taube, Factors associated with physical activity among COPD patients with mild or moderate airflow obstruction , Monaldi Archives for Chest Disease: Vol. 92 No. 1 (2022)
- Ombretta Para, Marco Vanetti, Chiara Dibonaventura, Davide Salerno, Lorenzo Caruso, Christian Carleo, Asim Raza, Carlo Nozzoli, Antonio Spanevello, Chronic obstructive pulmonary disease and heart failure in real life: the tip of the iceberg in the sea of comorbidities. A prospective observational study , Monaldi Archives for Chest Disease: Early Access
- Shweta Anand, Anshul Jain, Dipti Gothi, Sameer Vaidya, Rambabu Sah, Prevalence, risk factors and effects of restless legs syndrome in COPD patients , Monaldi Archives for Chest Disease: Vol. 93 No. 1 (2023)
- Pier Luigi Temporelli, Cardiopulmonary rehabilitation in patiens with heart failure and chronic pulmonary disease , Monaldi Archives for Chest Disease: Vol. 84 No. 1-2 (2015): Cardiac series
- Diletta Innocenti, Eleonora Masi, Giovanni Taccetti, Marco Genito, Elena Balestri, Anna Rita Berghelli, Maria Antonietta Ciciretti, Francesca Collini, Patrizia Fanzaghi, Annalisa Fogazzi, Paola Leone, Riccardo Guarise, Six minute walk test in Italian children with cystic fibrosis aged 6 and 11 , Monaldi Archives for Chest Disease: Vol. 92 No. 3 (2022)
- Iqbal Akhtar Khan, Paola Pierucci, Nicolino Ambrosino, COPD patients’ pre-flight check: A narrative review , Monaldi Archives for Chest Disease: Vol. 92 No. 4 (2022)
- Devika Tayal, Prerna Jain, Mamta Bhardwaj, Amit Sharma, Diabetes mellitus in acute exacerbation of chronic obstructive pulmonary disease – the tip of the iceberg , Monaldi Archives for Chest Disease: Vol. 94 No. 4 (2024)
- Federica Scimia, Isabella Casadei, Elena Cerquetani, Mara Piccoli, Alessandro Villa, Salvatore La Carrubba, Alessandro Salustri, Functional evaluation of ultra-octogenarian patients undergoing Cardiac Rehabilitation: correlation between Six minute Walking Test and Rivermead Mobility Index , Monaldi Archives for Chest Disease: Vol. 74 No. 4 (2010): Cardiac series
<< < 4 5 6 7 8 9 10 11 12 13 > >>
You may also start an advanced similarity search for this article.
