Serum amyloid a is a biomarker of acute exacerbations of chronic obstructive pulmonary disease.

نویسندگان

  • Steven Bozinovski
  • Anastasia Hutchinson
  • Michelle Thompson
  • Lochlan Macgregor
  • James Black
  • Eleni Giannakis
  • Anne-Sophie Karlsson
  • Roger Silvestrini
  • David Smallwood
  • Ross Vlahos
  • Louis B Irving
  • Gary P Anderson
چکیده

RATIONALE Much of the total disease burden and cost of chronic obstructive pulmonary disease (COPD) is associated with acute exacerbations of COPD (AECOPD). Serum amyloid A (SAA) is a novel candidate exacerbation biomarker identified by proteomic screening. OBJECTIVES To assess SAA as a biomarker of AECOPD. METHODS Biomarkers were assessed (1) cross-sectionally (stable vs. AECOPD; 62 individuals) and (2) longitudinally with repeated measures (baseline vs. AECOPD vs. convalescence; 78 episodes in 37 individuals). Event severity was graded (I, ambulatory; II, hospitalized; III, respiratory failure) based on consensus guidelines. MEASUREMENTS AND MAIN RESULTS Presumptively newly acquired pathogens were associated with onset of symptomatic AECOPD. In the cross-sectional study, both SAA and C-reactive protein (CRP) were elevated at AECOPD onset compared with stable disease (SAA median, 7.7 vs. 57.6 mg/L; P < 0.01; CRP median, 4.6 vs. 12.5 mg/L; P < 0.01). Receiver operator characteristics analysis was used to generate area-under-curve values for event severity. SAA discriminated level II/III events (SAA, 0.88; 95% confidence interval, 0.80-0.94 vs. CRP, 0.80; 95% confidence interval, 0.70-0.87; P = 0.05). Combining SAA or CRP with major symptoms (Anthonisen criteria, dyspnea) did not further improve the prediction model for severe episodes. IL-6 and procalcitonin were not informative. CONCLUSIONS SAA is a novel blood biomarker of AECOPD that is more sensitive than CRP alone or in combination with dyspnea. SAA may offer new insights into the pathogenesis of AECOPD.

برای دانلود متن کامل این مقاله و بیش از 32 میلیون مقاله دیگر ابتدا ثبت نام کنید

ثبت نام

اگر عضو سایت هستید لطفا وارد حساب کاربری خود شوید

منابع مشابه

The Relationship of Serum levels of Vascular Endothelial Growth Factor with Disease Severity and the Number of Exacerbations in COPD Patients

Background: Chronic Obstructive Pulmonary Disease (COPD) is a chronic lung disease characterized by progressive and irreversible obstruction of the airways of the lungs. Different studies have emphasized on the role of Vascular Endothelial Growth Factor (VEGF) in COPD patients. The aim of this study was to investigate the relationship of this factor with disease severity and th...

متن کامل

The role of serum surfactant protein D as a biomarker of exacerbation of chronic obstructive pulmonary disease

BACKGROUND The exacerbation of chronic obstructive pulmonary disease (COPD) is a major factor for the high mortality associated with the disease. There is a paucity in the lung-specific biomarkers which diagnose these exacerbations. Surfactant protein D (SP-D) is a promising biomarker in predicting clinical outcomes for patients with COPD, is lung-specific and can be detected in serum. However,...

متن کامل

Serum Surfactant Protein D during Acute Exacerbations of Chronic Obstructive Pulmonary Disease

BACKGROUND There is a paucity of lung specific biomarkers to diagnose exacerbations of chronic obstructive pulmonary disease (COPD) and to track their progression. Surfactant protein D (SP-D) is a pulmonary collectin regulating the innate immunity of the lung and its serum expression is perturbed in COPD. However, it is not known whether serum levels change during exacerbations. We sought to de...

متن کامل

The relationship between serum NT-pro BNP and the severity of the COPD exacerbation

Introduction: COPD is a common preventable disease characterized by airflow limitation that is not completely reversible.Acute exacerbation is prominent and serious features of COPD. Acute Exacerbation of COPD leads to hospitalization and concomitant with morbidity and mortality .The ventricular dysfunction increases serum Brain Natriuretic Peptide(BNP)  . This study was conducted to evaluate t...

متن کامل

COMPARISON OF THE ACUTE BRONCHO DILATING EFFECTS OF INHALED IPRATROPIUM BROMIDE AND SALBUTAMOL IN PATIENTS WI TH CHRONIC OBSTRUCTIVE PULMONARY DISE ASE

Forty-five patients with chronic obstructive pulmonary disease were studied to compare the acute effects of ipratropium bromide (60 µg), salbutamol (300 µg) and placebo (3 puffs) on the forced expiratory volume in 1 sec (FEV 1) and forced vital capacity (PVC). Ipratropium bromide produced a significantly greater improvement than salbutamol in both FEV1 and FVC at 15,60 and 180 minutes afte...

متن کامل

ذخیره در منابع من


  با ذخیره ی این منبع در منابع من، دسترسی به آن را برای استفاده های بعدی آسان تر کنید

برای دانلود متن کامل این مقاله و بیش از 32 میلیون مقاله دیگر ابتدا ثبت نام کنید

ثبت نام

اگر عضو سایت هستید لطفا وارد حساب کاربری خود شوید

عنوان ژورنال:
  • American journal of respiratory and critical care medicine

دوره 177 3  شماره 

صفحات  -

تاریخ انتشار 2008