中性粒细胞弹性蛋白酶作为 COPD 细菌感染的生物标志物。
Neutrophil elastase as a biomarker for bacterial infection in COPD.
机构信息
Respiratory Medicine Unit, Nuffield Department of Medicine, John Radcliffe Hospital, University of Oxford, Level 7, Oxford, OX3 7DU, UK.
Oxford NIHR Biomedical Research Centre, University of Oxford, Oxford, UK.
出版信息
Respir Res. 2019 Jul 30;20(1):170. doi: 10.1186/s12931-019-1145-4.
BACKGROUND
Chronic obstructive pulmonary disease (COPD) is predominantly associated with neutrophilic inflammation. Active neutrophil elastase (NE) is a serine proteinase, secreted by neutrophils, in response to inflammation and pathogen invasion. We sought to investigate if NE could be used as a biomarker for bacterial infection in patients with COPD.
METHODS
NE was quantified using ProteaseTag® Active NE Immunoassay (ProAxsis, Belfast) from the sputum of COPD subjects at stable state, exacerbation and 2 weeks post treatment visit.
RESULTS
NE was measured in 90 samples from 30 COPD subjects (18 males) with a mean (range) age of 65 (45-81) years and mean (SD) FEV of 47% (18). The geometric mean (95%CI) of NE at stable state was 2454 ng/mL (1460 to 4125 ng/mL). There was a significant increase in NE levels at an exacerbation (p = 0.003), and NE levels were higher in a bacterial-associated exacerbation (NE log difference 3.873, 95% CI of log difference 1.396 to 10.740, p = 0.011). NE was an accurate predictor of a bacteria-associated exacerbation (area (95%CI) under the receiver operator characteristic curve 0.812 (0.657 to 0.968).
CONCLUSION
NE is elevated during exacerbations of COPD. NE may be a viable biomarker for distinguishing a bacterial exacerbation in patients with COPD.
TRIAL REGISTRATION
Leicestershire, Northamptonshire and Rutland ethics committee (reference number: 07/H0406/157).
背景
慢性阻塞性肺疾病（COPD）主要与中性粒细胞炎症有关。活性中性粒细胞弹性蛋白酶（NE）是一种由中性粒细胞分泌的丝氨酸蛋白酶，对炎症和病原体入侵作出反应。我们试图研究 NE 是否可作为 COPD 患者细菌感染的生物标志物。
方法
使用 ProteaseTag® Active NE Immunoassay（ProAxsis，贝尔法斯特）在 COPD 患者稳定期、加重期和治疗后 2 周时定量检测痰中的 NE。
结果
在 30 例 COPD 患者（18 名男性）的 90 份样本中测量了 NE，患者年龄中位数（范围）为 65（45-81）岁，FEV 中位数（SD）为 47%（18%）。稳定期的 NE 几何均数（95%CI）为 2454ng/ml（1460 至 4125ng/ml）。在加重期 NE 水平显著升高（p=0.003），且与细菌相关的加重期 NE 水平更高（NE 对数差 3.873，95%CI 对数差 1.396 至 10.740，p=0.011）。NE 是细菌相关加重期的准确预测因子（受试者工作特征曲线下面积（95%CI）为 0.812（0.657 至 0.968）。
结论
在 COPD 加重期，NE 升高。NE 可能是区分 COPD 患者细菌加重的可行生物标志物。
试验注册
莱斯特郡、北安普敦郡和拉特兰道德委员会（参考编号：07/H0406/157）。
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