Liu Shih-Feng, Chin Chien-Hung, Wang Chin-Chou, Lin Meng-Chih
Division of Pulmonary, Department of Internal Medicine, Chang Gung Memorial Hospital- Kaohsiung Medical Center, Kaohsiung Hsien, Taiwan.
Respirology. 2009 Sep;14(7):999-1004. doi: 10.1111/j.1440-1843.2009.01608.x.
The BODE index, based on BMI, obstructive ventilatory impairment, dyspnoea scale and exercise capacity, has been used to evaluate the severity of patients with COPD. However, the correlations between serum biomarkers and the BODE index in patients with stable COPD are not widely studied. This study evaluated potential serum biomarkers for their ability to identify smokers with COPD and reflect disease severity.
A comparative study was conducted of 100 clinically stable COPD patients and 50 matched healthy smokers and the difference in levels of biomarkers between the COPD patients and healthy smokers was measured. Serum inflammatory mediators measured were growth-related oncogene-alpha (GRO-alpha), IL-8, tumour necrosis factor-alpha (TNF-alpha), matrix metalloproteinase-9 (MMP-9) and monocyte chemoattractant protein-1 (MCP-1). Variables included age, pack-years, current or ex-smoker status, inhaler or oral steroid use and BODE index components, including airflow obstruction, the distance walked in 6MWD, modified Medical Research Council (MMRC) dyspnoea scale and BMI. The association between serum biomarkers and the components of the BODE index was assessed in the COPD patients.
The level of serum MCP-1 was significantly different between the COPD group and the healthy smoker group (P = 0.003). Significant results in univariate and multivariate analysis of the association between biomarkers and BODE components were: serum MCP-1 correlated with FEV(1)% and 6MWD; serum IL-8 and GRO-alpha correlated with steroid use; serum TNF-alpha correlated with steroid use and FEV(1)%; and serum MMP-9 correlated with MMRC dyspnoea scale.
No single specific serum inflammatory mediator was completely correlated with BODE variable parameters in patients with stable COPD. Serum MCP-1 may be an important biomarker for identifying COPD subjects from healthy smokers and classifying COPD severity.
基于体重指数（BMI）、阻塞性通气功能障碍、呼吸困难分级和运动能力的BODE指数，已用于评估慢性阻塞性肺疾病（COPD）患者的严重程度。然而，稳定期COPD患者血清生物标志物与BODE指数之间的相关性尚未得到广泛研究。本研究评估了潜在血清生物标志物识别COPD吸烟者及反映疾病严重程度的能力。
对100例临床稳定的COPD患者和50例匹配的健康吸烟者进行了一项对比研究，测量了COPD患者与健康吸烟者之间生物标志物水平的差异。检测的血清炎症介质包括生长相关癌基因α（GRO-α）、白细胞介素-8（IL-8）、肿瘤坏死因子-α（TNF-α）、基质金属蛋白酶-9（MMP-9）和单核细胞趋化蛋白-1（MCP-1）。变量包括年龄、吸烟包年数、当前或既往吸烟状态、吸入或口服类固醇使用情况以及BODE指数成分，包括气流阻塞、6分钟步行距离（6MWD）、改良医学研究委员会（MMRC）呼吸困难分级和BMI。在COPD患者中评估了血清生物标志物与BODE指数成分之间的关联。
COPD组与健康吸烟者组血清MCP-1水平存在显著差异（P = 0.003）。生物标志物与BODE成分之间关联的单因素和多因素分析的显著结果为：血清MCP-1与第1秒用力呼气容积百分比（FEV₁%）和6MWD相关；血清IL-8和GRO-α与类固醇使用相关；血清TNF-α与类固醇使用和FEV₁%相关；血清MMP-9与MMRC呼吸困难分级相关。
在稳定期COPD患者中，没有单一的特定血清炎症介质与BODE可变参数完全相关。血清MCP-1可能是从健康吸烟者中识别COPD受试者并对COPD严重程度进行分类的重要生物标志物。
