Blood Specimen Biomarkers of Inflammation, Matrix Degradation, Angiogenesis, and Cardiac Involvement: a Future Useful To
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REVIEW
Blood Specimen Biomarkers of Inflammation, Matrix Degradation, Angiogenesis, and Cardiac Involvement: a Future Useful Tool in Assessing Clinical Outcomes of COPD Patients in Clinical Practice? Sabina Skrgat Kristan
Received: 4 August 2012 / Accepted: 13 May 2013 Ó L. Hirszfeld Institute of Immunology and Experimental Therapy, Wroclaw, Poland 2013
Abstract Chronic obstructive pulmonary disease (COPD) is characterized by airflow limitation that is not fully reversible; this airflow limitation is both progressive and associated with an abnormal inflammatory response of the lung to noxious particles or gasses. COPD is undoubtedly an umbrella term, and it seems unlikely that all patients with COPD have the same underlying disease processes; thus, there is a need for differential treatment of different subgroups. A potential solution is to find modifiable biomarkers that can assist in drug development and distinguish subgroups of COPD. With the exception of lung function tests, there are currently no well-validated biomarkers or surrogate endpoints that can be used to establish the efficacy of a drug for COPD. This article discusses biomarkers of inflammation (fibrinogen, C-reactive protein, pulmonary and activation-regulated chemokine/CC-chemokine ligand18, serum surfactant protein D, interleukin (IL)-6, IL-8 and tumor necrosis factor a, complement factor C5a), angiogenesis factors as a part of the pathogenetic aspect in this disease (vascular endothelial growth factor, angiogenin, and IL-8), and matrix degradation biomarkers. Troponin and natriuretic peptides are presented as biomarkers of cardiac involvement in the light of COPD comorbidities. Trials based on research on known clinical variables such as FEV1, BODE, and 6MWT in combination with biomarkers from lung and blood specimens will probably clarify part of the prognosis and natural history of the disease. This will also represent an additional step in COPD phenotyping and new treatment possibilities.
S. S. Kristan (&) University Clinic of Respiratory and Allergic Diseases, Golnik, Slovenia e-mail: [email protected]
Keywords Chronic obstructive pulmonary disease Biomarkers Angiogenic factors Desmosine Natriuretic peptides Troponin T Complement
Introduction Chronic obstructive pulmonary disease, the fourth-leading cause of death worldwide, is characterized by airflow limitation that is not fully reversible; this airflow limitation is both progressive and associated with an abnormal inflammatory response of the lung to noxious particles or gasses (Pauwels et al. 2001; World Health Organization 2008). Forced expiratory volume in one second (FEV1) is the traditional marker used to define the progression of COPD and the strongest spirometric predictor of mortality in COPD patients (Thomason and Strachan 2000). Factors that affect the decline in pulmonary function viewed through FEV1 are cigarette smoking and exacerbation frequency (Anthonisen et al. 1994; Donaldson et al. 2002). A number of risk factors have been associated with
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