Zhao, D, Abbasi, A, Rossiter, HB orcid.org/0000-0002-7884-0726 et al. (11 more authors) (2020) Serum Amyloid A in Stable COPD Patients is Associated with the Frequent Exacerbator Phenotype. International Journal of Chronic Obstructive Pulmonary Disease, 15. pp. 2379-2388. ISSN 1178-2005
Abstract
Background: We sought to determine whether circulating inflammatory biomarkers were associated with the frequent exacerbator phenotype in stable COPD patients ie, those with two or more exacerbations in the previous year.
Methods: Eighty-eight stable, severe, COPD patients (4 females) were assessed for exacerbation frequency, pulmonary function, fraction of expired nitric oxide (FENO); inflammatory variables were measured in venous blood. Logistic regression assessed associations between the frequent exacerbator phenotype and systemic inflammation.
Results: Compared with infrequent exacerbators, frequent exacerbators (n=10; 11.4%) had greater serum concentration (median (25th-75th quartile)) of serum amyloid A (SAA; 134 (84– 178) vs 71 (38– 116) ng/mL; P=0.024), surfactant protein D (SP-D; 15.6 (9.0– 19.3) vs 8.5 (3.6– 14.9) ng/mL; P=0.049) and interleukin-4 (IL-4; 0.12 (0.08– 1.44) vs 0.03 (0.01– 0.10) pg/mL; P=0.001). SAA, SP-D and IL-4 were not significantly correlated with FEV1%predicted or FVC %predicted. After adjusting for sex, age, BMI, FEV1/FVC and smoking pack-years, only SAA remained independently associated with the frequent exacerbator phenotype (OR 1.49[1.09– 2.04]; P=0.012). The odds of being a frequent exacerbator was 18-times greater in the highest SAA quartile (≥ 124.1 ng/mL) than the lowest SAA quartile (≤ 44.1 ng/mL) (OR 18.34[1.30– 258.81]; P=0.031), and there was a significant positive trend of increasing OR with increasing SAA quartile (P=0.008). For SAA, the area under the receiver operating characteristic curve was 0.721 for identification of frequent exacerbators; an SAA cut-off of 87.0 ng/mL yielded an 80% sensitivity and 61.5% specificity.
Conclusion: In stable COPD patients, SAA was independently associated with the frequent exacerbator phenotype, suggesting that SAA may be a useful serum biomarker to inform progression or management in COPD.
Metadata
Item Type: | Article |
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Authors/Creators: |
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Copyright, Publisher and Additional Information: | © 2020 Zhao et al. This work is published and licensed by Dove Medical Press Limited. The full terms of this license are available at https://www.dovepress.com/terms.php and incorporate the Creative Commons Attribution – Non Commercial (unported, v3.0) License (CC BY-NC 3.0) (http://creativecommons.org/licenses/by-nc/3.0/) |
Keywords: | inflammation, surfactant protein D, interleukin-4 |
Dates: |
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Institution: | The University of Leeds |
Academic Units: | The University of Leeds > Faculty of Biological Sciences (Leeds) > School of Biomedical Sciences (Leeds) |
Depositing User: | Symplectic Publications |
Date Deposited: | 14 Oct 2020 11:41 |
Last Modified: | 14 Oct 2020 11:41 |
Status: | Published |
Publisher: | Dove Medical Press |
Identification Number: | 10.2147/copd.s266844 |
Open Archives Initiative ID (OAI ID): | oai:eprints.whiterose.ac.uk:166613 |
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