Inflammatory and repair serum biomarker pattern. Association to clinical outcomes in COPD
Date
2012Abstract
Background: The relationship between serum biomarkers and clinical expressions of COPD is limited. We planned
to further describe this association using markers of inflammation and injury and repair.
Methods: We studied lung function, comorbidities, exercise tolerance, BODE index, and quality of life in 253 COPD
patients and recorded mortality over three years. Serum levels of Interleukins 6,8 and16, tumor necrosis factor alpha
(TNF α) [inflammatory panel], vascular endothelial growth factor (VEGF), and matrix metalloproteinase 9 (MMP-9)
[injury and repair panel] and pulmonary and activation-regulated chemokine (PARC/CCL-18) and monocyte
chemotactic protein 1 (MCP-1/CCL2) [chemoattractant panel] were measured. We related the pattern of the
biomarker levels to minimal clinically important differences (MCID) using a novel visualization method [ObServed
Clinical Association Results (OSCAR) plot].
Results: Levels of the inflammatory markers IL-6, TNF α were higher and those of injury and repair lower (p < 0.01)
with more advanced disease (GOLD 1 vs. 4). Using the OSCAR plot, we found that patients in the highest quartile
of inflammatory and lowest quartile of injury and repair biomarkers level were more clinically compromised and
had higher mortality (p < 0.05).
Conclusions: In COPD, serum biomarkers of inflammation and repair are distinctly associated with important
clinical parameters and survival.