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VOLUME 60 , ISSUE 4 ( October-December, 2018 ) > List of Articles

Original Article

Inflammatory Biomarkers in Chronic Obstructive Pulmonary Disease

Sunil A. Kumar, K Rakul Nambiar, A Ravikumar Kurup

Keywords : COPD, Severity, Exacerbations, Inflammatory markers

Citation Information : Kumar SA, Nambiar KR, Kurup AR. Inflammatory Biomarkers in Chronic Obstructive Pulmonary Disease. Indian J Chest Dis Allied Sci 2018; 60 (4):233-237.

DOI: 10.5005/ijcdas-60-4-233

License: CC BY-NC 4.0

Published Online: 18-11-2022

Copyright Statement:  Copyright © 2018; The Author(s).


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.

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  1. Deng ZC, Zhao P, Cao C, Sun SF, Zhao F, Lu CY, et al. C-reactive protein as a prognostic marker in chronic obstructive pulmonary disease. Exp Therapeutic Med 2014;7:443–6.
  2. Vestbo J, Hurd SS, Agustí AG, Jones PW, Vogelmeier C, Anzueto A, et al. Global strategy for the diagnosis, management, and prevention of chronic obstructive pulmonary disease: GOLD executive summary. Am J Respir Crit Care Med 2013;187:347–65.
  3. De S. Body mass index among patient with chronic obstructive pulmonary diseases. Indian J Physiol Pharmacol 2012;56:353–8.
  4. Mannino DM, Valvi D, mullerova H, Tal-Singer R. Fibrinogen, COPD and mortality in a nationally representative U.S. Cohort. J Chronic Obstr Pulm Dis 2012;9:359–66.
  5. Miniati M, Monti S, Bottai M, Cocci F, Fornai E, Lubrano V. Prognostic value of C-reactive protein in chronic obstructive pulmonary disease. Intern Emerg Med 2011;6:423–30.
  6. de Torres JP, Pinto-Plata V, Casanova C, Mullerova H, Córdoba-Lanús E, de Fuentes MM, et al. C-reactive protein levels and survival in patients with moderate to very severe COPD. Chest 2008;133:1336–43.
  7. Cowburn AS, Condliffe AM, Farahi N, Summers C, Chilvers ER. Advances in neutrophil biology. Chest 2008;134:606–12.
  8. Mackie IJ, Kitchen S, Machin SJ, Lowe GD. Guidelines on fibrinogen assays. Br J Haematol 2003;121:396–404.
  9. Wedzicha JA, Seemungal TA, MacCallum PK, Paul EA, Donaldson GC, Bhowmik A, et al. Acute exacerbations of chronic obstructive pulmonary disease are accompanied by elevations of plasma fibrinogen and serum IL-6 levels. Thromb Haemost 2000;84:210–5.
  10. Alessandri C, Basili S, Violi F, Ferroni P, Gazzaniga PP, Cordova C for Chronic Obstructive Bronchitis and Haemostasis Group. Hypercoagulability state in patients with chronic obstructive pulmonary disease. Thromb Haemost 1994;72:343–6.
  11. Engstrom G, Segelstorm N, Ekberg-Aronsson M, Nilsson PM, Lindgarde F, Lofdahl C-G. Plasma markers of inflammation and incidence of hospitalisations for COPD: results from a population-based cohort study. Thorax 2009;64:211–5.
  12. Groenewegen KH, Postma DS, Hop WCJ, Wielders PLML, Schlösser NJJ, Wouters EFM. Increased systemic inflammation is a risk factor for COPD exacerbations. Chest 2008;133:350–7.
  13. Kalhan R, Tran BT, Colangelo LA, Rosenberg SR, Liu K, Thyagarajan B, et al. Systemic inflammation in young adults is associated with abnormal lung function in middle age. PLoS One 2010;5:e11431.
  14. Jiang R, Burke GL, Enright PL, Newman AB, Margolis HG, Cushman M, et al. Inflammatory markers and longitudinal lung function decline in the elderly. Am J Epidemiol 2008;168:602–10.
  15. Donaldson GC, Seemungal TAR, Patel IS, Bhowmik A, Wilkinson TMA, Hurst JR, et al. Airway and systemic inflammation and decline in lung function in patients with COPD. Chest 2005;128:1995–2004.
  16. Gan WQ. Association between chronic obstructive pulmonary disease and systemic inflammation: a systematic review and a meta-analysis. Thorax 2004;59:574–80.
  17. Thomsen M, Ingebrigtsen TS, Marott JL, Dahl M, Lange P, Vestbo J, et al. Inflammatory biomarkers and exacerbations in chronic obstructive pulmonary disease. JAMA 2013;309:2353–61.
  18. Corsonello A, Pedone C, Battaglia S, Paglino G, Bellia V, Incalzi RA. C-reactive protein (CRP) and erythrocyte sedimentation rate (ESR) as inflammation markers in elderly patients with stable chronic obstructive pulmonary disease (COPD). Arch Gerontol Geriatr 2011;53:190–5.
  19. Firouzjahi A, Monadi M, Karimpoor F, Heidari B, Dankoob Y, Hajian-Tilaki K, et al. Serum C-reactive protein level and distribution in chronic obstructive pulmonary disease versus healthy controls: a case–control study from Iran. Inflammation 2013;36:1122–8.
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