help button home button
AJRCCM
HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH
Published ahead of print on June 23, 2006, doi:10.1164/rccm.200604-506OC

Am. J. Respir. Crit. Care Med., Volume 174, Number 8, October 2006, 867-874

A more recent version of this article appeared on October 15, 2006
This Article
Right arrow Full Text (PDF)
Right arrow All Versions of this Article:
200604-506OCv1
174/8/867    most recent
Right arrow Alert me when this article is cited
Right arrow Alert me if a correction is posted
Services
Right arrow Similar articles in this journal
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Download to citation manager
Right arrow reprints & permissions
Citing Articles
Right arrow Citing Articles via HighWire
Right arrow Citing Articles via Google Scholar
Google Scholar
Right arrow Articles by Hurst, J. R
Right arrow Articles by Wedzicha, J. A
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by Hurst, J. R
Right arrow Articles by Wedzicha, J. A

Submitted on April 11, 2006
Accepted on June 23, 2006

Utility of Plasma Biomarkers at Exacerbation of Chronic Obstructive Pulmonary Disease

John R Hurst1, Gavin C Donaldson1, Wayomi R Perea1, Tom MA Wilkinson1, John A Bilello2, Gerry W Hagan3, Rupert S Vessey4, and Jadwiga A Wedzicha1*

1 Academic Unit of Respiratory Medicine, Royal Free and University College Medical School, London, United Kingdom, 2 Research and Development, GlaxoSmithKline, Research Triangle Park, NC, USA, 3 Research and Development, GlaxoSmithKline, Greenford, Middlesex, United Kingdom, 4 Research and Development, GlaxoSmithKline, Upper Merion, PA, USA

* To whom correspondence should be addressed. E-mail: j.a.wedzicha{at}medsch.ucl.ac.uk.

RATIONALE: The utility of measuring CRP (C-reactive protein) to confirm exacerbation, or assess exacerbation severity in chronic obstructive pulmonary disease (COPD) is unclear. Furthermore, it is not known whether there may be more useful systemic biomarkers. OBJECTIVE: To assess the utility of plasma biomarkers in confirming exacerbation and predicting exacerbation severity. METHODS: We assessed 36 biomarkers in 90 paired baseline and exacerbation plasma samples from 90 patients with COPD. The diagnosis of exacerbation fulfilled both health-care utilisation and symptom-based criteria. Biomarker concentrations were related to clinical indices of exacerbation severity. Inter-relationships between biomarkers were examined to inform on mechanisms of systemic inflammation at exacerbation of COPD. MEASUREMENTS and MAIN RESULTS: To confirm the diagnosis of exacerbation, the most selective biomarker was CRP. However, this was neither sufficiently sensitive nor specific alone (area under the receiver operating characteristic curve, AUC=0.73, 95% confidence interval, CI 0.66-0.80). The combination of CRP with any one increased major exacerbation symptom recorded by the patient on that day (dyspnoea, sputum volume or sputum purulence) significantly increased the AUC to 0.88, 95%CI 0.82-0.93, p<0.0001. There were no significant relationships between biomarker concentrations and clinical indices of exacerbation severity. Inter-relationships between biomarkers suggest that the acute-phase response is related, separately, to monocytic and lymphocytic-neutrophilic pathways. CONCLUSIONS: Plasma CRP concentration, in the presence of a major exacerbation symptom, is useful in the confirmation of COPD exacerbation. Systemic biomarkers were not helpful in predicting exacerbation severity. The acute-phase response at exacerbation was most strongly related to indices of monocyte function.
Key words: COPD, Inflammation, Exacerbation




This article has been cited by other articles:


Home page
 Eur Respir JHome page
Z. L. Borrill, K. Roy, and D. Singh
Exhaled breath condensate biomarkers in COPD
Eur. Respir. J., August 1, 2008; 32(2): 472 - 486.
[Abstract] [Full Text] [PDF]

Home page
 ChestHome page
D. Stolz, M. Christ-Crain, N. G. Morgenthaler, D. Miedinger, J. Leuppi, C. Muller, R. Bingisser, J. Struck, B. Muller, and M. Tamm
Plasma Pro-Adrenomedullin But Not Plasma Pro-Endothelin Predicts Survival in Exacerbations of COPD
Chest, August 1, 2008; 134(2): 263 - 272.
[Abstract] [Full Text] [PDF]

Home page
 ChestHome page
D. D. Sin and S. F. P. Man
Biomarkers in COPD: Are We There Yet?
Chest, June 1, 2008; 133(6): 1296 - 1298.
[Full Text] [PDF]

Home page
 ChestHome page
J. P. de Torres, V. Pinto-Plata, C. Casanova, H. Mullerova, E. Cordoba-Lanus, M. Muros de Fuentes, A. Aguirre-Jaime, and B. R. Celli
C-Reactive Protein Levels and Survival in Patients With Moderate to Very Severe COPD
Chest, June 1, 2008; 133(6): 1336 - 1343.
[Abstract] [Full Text] [PDF]

Home page
 Proc Am Thorac SocHome page
N. MacIntyre and Y. C. Huang
Acute Exacerbations and Respiratory Failure in Chronic Obstructive Pulmonary Disease
Proceedings of the ATS, May 1, 2008; 5(4): 530 - 535.
[Abstract] [Full Text] [PDF]

Home page
 Eur Respir JHome page
M. Cazzola, W. MacNee, F. J. Martinez, K. F. Rabe, L. G. Franciosi, P. J. Barnes, V. Brusasco, P. S. Burge, P. M. A. Calverley, B. R. Celli, et al.
Outcomes for COPD pharmacological trials: from lung function to biomarkers
Eur. Respir. J., February 1, 2008; 31(2): 416 - 469.
[Abstract] [Full Text] [PDF]

Home page
 Am. J. Respir. Crit. Care Med.Home page
S. Bozinovski, A. Hutchinson, M. Thompson, L. MacGregor, J. Black, E. Giannakis, A.-S. Karlsson, R. Silvestrini, D. Smallwood, R. Vlahos, et al.
Serum Amyloid A Is a Biomarker of Acute Exacerbations of Chronic Obstructive Pulmonary Disease
Am. J. Respir. Crit. Care Med., February 1, 2008; 177(3): 269 - 278.
[Abstract] [Full Text] [PDF]

Home page
 CirculationHome page
M. K. Han, V. V. McLaughlin, G. J. Criner, and F. J. Martinez
Pulmonary Diseases and the Heart
Circulation, December 18, 2007; 116(25): 2992 - 3005.
[Abstract] [Full Text] [PDF]

Home page
 Proc Am Thorac SocHome page
J. A. Wedzicha and J. R. Hurst
Structural and Functional Co-conspirators in Chronic Obstructive Pulmonary Disease Exacerbations
Proceedings of the ATS, December 1, 2007; 4(8): 602 - 605.
[Abstract] [Full Text] [PDF]

Home page
 Proc Am Thorac SocHome page
E. F. M. Wouters, K. H. Groenewegen, M. A. Dentener, and J. H. J. Vernooy
Systemic Inflammation in Chronic Obstructive Pulmonary Disease: The Role of Exacerbations
Proceedings of the ATS, December 1, 2007; 4(8): 626 - 634.
[Abstract] [Full Text] [PDF]

Home page
 Proc Am Thorac SocHome page
F. J. Martinez
Pathogen-directed Therapy in Acute Exacerbations of Chronic Obstructive Pulmonary Disease
Proceedings of the ATS, December 1, 2007; 4(8): 647 - 658.
[Abstract] [Full Text] [PDF]

Home page
 Eur Respir JHome page
G. Viegi, F. Pistelli, D. L. Sherrill, S. Maio, S. Baldacci, and L. Carrozzi
Definition, epidemiology and natural history of COPD
Eur. Respir. J., November 1, 2007; 30(5): 993 - 1013.
[Abstract] [Full Text] [PDF]

Home page
 ChestHome page
J. R. Hurst, G. Hagan, J. A. Wedzicha, and F. Frost
Mechanism of Statin-Associated Mortality Reduction in COPD
Chest, October 1, 2007; 132(4): 1409 - 1410.
[Full Text] [PDF]

Home page
 ThoraxHome page
V. Pinto-Plata, J. Toso, K. Lee, D. Park, J. Bilello, H. Mullerova, M. M De Souza, R. Vessey, and B. Celli
Profiling serum biomarkers in patients with COPD: associations with clinical parameters
Thorax, July 1, 2007; 62(7): 595 - 601.
[Abstract] [Full Text] [PDF]

Home page
 Am. J. Respir. Crit. Care Med.Home page
K. F. Rabe, B. Beghe, F. Luppi, and L. M. Fabbri
Update in Chronic Obstructive Pulmonary Disease 2006
Am. J. Respir. Crit. Care Med., June 15, 2007; 175(12): 1222 - 1232.
[Full Text] [PDF]

Home page
 Eur Respir JHome page
B. R. Celli and P. J. Barnes
Exacerbations of chronic obstructive pulmonary disease
Eur. Respir. J., June 1, 2007; 29(6): 1224 - 1238.
[Abstract] [Full Text] [PDF]

Home page
 ChestHome page
D. Stolz, M. Christ-Crain, N. G. Morgenthaler, J. Leuppi, D. Miedinger, R. Bingisser, C. Muller, J. Struck, B. Muller, and M. Tamm
Copeptin, C-Reactive Protein, and Procalcitonin as Prognostic Biomarkers in Acute Exacerbation of COPD
Chest, April 1, 2007; 131(4): 1058 - 1067.
[Abstract] [Full Text] [PDF]

Home page
 Eur Respir JHome page
M. N. Hylkema, P. J. Sterk, W. I. de Boer, and D. S. Postma
Tobacco use in relation to COPD and asthma
Eur. Respir. J., March 1, 2007; 29(3): 438 - 445.
[Abstract] [Full Text] [PDF]

Home page
 ThoraxHome page
J R Hurst and J A Wedzicha
What is (and what is not) a COPD exacerbation: thoughts from the new GOLD guidelines
Thorax, March 1, 2007; 62(3): 198 - 199.
[Full Text] [PDF]

Home page
 Am. J. Respir. Crit. Care Med.Home page
B. Muller and M. Tamm
Biomarkers in acute exacerbation of chronic obstructive pulmonary disease: among the blind, the one-eyed is king.
Am. J. Respir. Crit. Care Med., October 15, 2006; 174(8): 848 - 849.
[Full Text] [PDF]


HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH
Proc. Am. Thorac. Soc. Am. J. Respir. Cell Mol. Biol.
Copyright © 2006 American Thoracic Society