Value of metalloproteinases in predicting COPD in heavy urban smokers
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RESEARCH
Open Access
Value of metalloproteinases in predicting COPD in heavy urban smokers Jun-Chieh J. Tsay1*† , Yingjie Hu2†, Judith D. Goldberg2, Bin Wang2, Soumya Vijayalekshmy1, Ting-An Yie1, Katrina Bantis1, Daniel H. Sterman1 and William N. Rom1
Abstract Background: Emphysema in asymptomatic heavy smokers can be detected during CT-scan screening for lung cancer. Metalloproteinases (MMPs) have been found to play a role in the pathogenesis of chronic obstructive pulmonary disease and to possibly serve as biomarkers for emphysema. Methods: The NYU Lung Cancer Biomarker Center enrolled study subjects over 50 years of age with lung cancer risk factors from January 1, 2010, to December 31, 2015. These subjects received chest multi-detector computed tomography, spirometry, and provided serum for immunoassays for metalloproteinases (MMP) -1, -2, -7, -9, -10 and tissue inhibitor of metalloproteinases (TIMP) -1 and -2. Results: Three hundred sixteen study subjects were enrolled. Of the 222 patients who met the inclusion criteria, 46% had emphysema. Smokers with emphysema had increased pack-years of smoking compared to smokers without emphysema (51 ± 24 pack-years (mean ± sd) versus 37 ± 20; p < 0.0001). Smokers with emphysema also had lower FEV1/FVC percent compared to smokers without emphysema (68 ± 11 (mean ± sd) versus 75 ± 8; p < 0.0001). Increased age and pack-years of smoking were associated with increased odds of emphysema. None of the metalloproteinases or tissue inhibitors of metalloproteinases were useful to predict the presence of emphysema in smokers. Conclusion: Emphysema was detected by CT in almost half of heavy urban smokers. Serum MMP levels provided minimal additional information to improve the detection of mild emphysema among smokers given their clinical characteristics (age, pack-years, and FEV1/FVC ratio).
Introduction In the United States, the prevalence of chronic obstructive pulmonary disease (COPD) is estimated to be 24 million individuals, of which half remains undiagnosed, and it is the third leading cause of death worldwide [1]. Detection of emphysema may act as a catalyst for patients to quit smoking and subsequently prevent worsening lung function. While the U.S. Preventive Services Task * Correspondence: [email protected] † Jun-Chieh Tsay and Yingjie Hu are contributed equally as first authors. 1 William N. Rom Environmental Lung Disease Laboratory, Division of Pulmonary, Critical Care, and Sleep Medicine, Department of Medicine, and Department of Environmental Medicine, New York University School of Medicine, New York, NY, USA Full list of author information is available at the end of the article
Force recommends against screening adults for COPD using spirometry [2, 3], the respiratory societies do recommend spirometry for adults with respiratory symptoms, especially dyspnea [4]. Among the > 20,000 randomly selected participants in a large population based survey, the prevalence of COPD was 8.2%, however only 6.5% of these diagnosed subjects had ever been examined with spirometry
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