Department of Respiratory and Critical Care Medicine, West China Hospital of Sichuan University and Division of Pulmonary Diseases, State Key Laboratory of Biotherapy of China, Chengdu 610041, People's Republic of China.
Department of Internal Medicine, Sichuan Provincial People's Hospital and Sichuan Academy of Medical Science, Chengdu 610072, People's Republic of China.
Int J Chron Obstruct Pulmon Dis. 2019 Aug 28;14:1933-1941. doi: 10.2147/COPD.S207855. eCollection 2019.
Patients with COPD often show increased systemic inflammation which is associated with lower functional status, greater exacerbation risk, and worse clinical outcomes. Syndecans (SDCs), a family of transmembrane heparan sulfate proteoglycans (HSPGs), have been found to involve in inflammatory processes in many chronic inflammatory diseases. The aim of this preliminary clinical study was to investigate the possible association between two SDCs, SDC-1 and SDC-4, with lung function, systemic inflammation, and risk of exacerbations in COPD patients.
Serum SDC-1 and SDC-4 levels were measured in 101 COPD patients and 57 health controls. Correlations between SDCs and other parameters were analyzed using Spearsman's rho. Receiver operating curve (ROC) analysis was used to evaluate the threshold value in differentiating disease status.
Although both serum SDC-1 and SDC-4 showed a downward trend in COPD patients, only SDC-1 levels were correlated positively with the ratio of FEV1/FVC and parameters of small airway obstruction. Besides, SDC-1 but not SDC-4, was negatively correlated with C-reactive protein (CRP) in COPD patients and downregulated in frequent exacerbators (FEs) of COPD. Using a cutoff value of 2.08 ng/mL, the sensitivity and specificity of SDC-1 to differentiate FE were 44% and 93.4%, respectively.
In conclusion, circulating SDC-1 may be a novel inflammatory biomarker associated with lung function and systemic inflammation in patients with COPD, which could also be useful to identify the risk of COPD exacerbation. Further studies should be performed to clarify the influences of SDC-1 on the pathogenesis and outcomes of COPD.
COPD 患者常表现出全身性炎症增加，这与功能状态降低、加重风险增加和临床预后恶化有关。黏附素（SDCs）是一种跨膜硫酸乙酰肝素蛋白聚糖（HSPGs）家族，已被发现参与许多慢性炎症性疾病的炎症过程。本初步临床研究旨在探讨两种 SDCs（SDC-1 和 SDC-4）与 COPD 患者的肺功能、全身炎症和加重风险之间的可能关联。
测量了 101 例 COPD 患者和 57 例健康对照者的血清 SDC-1 和 SDC-4 水平。使用斯皮尔曼 rho 分析 SDCs 与其他参数之间的相关性。使用接收者操作曲线（ROC）分析评估区分疾病状态的阈值值。
虽然 COPD 患者的血清 SDC-1 和 SDC-4 均呈下降趋势，但只有 SDC-1 水平与 1 秒率（FEV1/FVC）的比值和小气道阻塞的参数呈正相关。此外，SDC-1 而不是 SDC-4，与 COPD 患者的 C 反应蛋白（CRP）呈负相关，在 COPD 的频繁加重者（FE）中下调。使用 2.08ng/ml 的截断值，SDC-1 区分 FE 的敏感性和特异性分别为 44%和 93.4%。
总之，循环 SDC-1 可能是一种与 COPD 患者肺功能和全身炎症相关的新型炎症生物标志物，也可能有助于识别 COPD 加重的风险。应进一步研究以阐明 SDC-1 对 COPD 发病机制和结局的影响。
