Department of Internal Medicine, Faculty of Medicine, "Vasile Goldiș" Western University of Arad, 310025 Arad, Romania.
Arad County Emergency Clinical Hospital, 310037 Arad, Romania.
Medicina (Kaunas). 2023 Feb 16;59(2):383. doi: 10.3390/medicina59020383.
Bronchial asthma (BA) and chronic obstructive pulmonary disease (COPD) are not only common obstructive respiratory conditions but also major causes of morbidity and mortality worldwide. There is, however, a surprising lack of blood-based biomarkers for separating between these pulmonary disorders. The aim of this study was to assess the practical relevance of using serum YKL-40, single or combined, for this purpose. : Subjects included Romanian patients with BA ( = 24) or COPD ( = 27). YKL-40, fibrinogen, pre-treatment C-reactive protein (CRP), post-treatment CRP, erythrocyte sedimentation rate, interleukin 6 (IL-6), procalcitonin (PCT), absolute neutrophil count, neutrophil percentage, absolute lymphocyte count, lymphocyte percentage, absolute eosinophil count, and eosinophil percentage were measured and compared between these patients. : This is the first study investigating the clinical significance of serum YKL-40 in delineating between COPD and BA in Caucasian populations. Only fibrinogen and YKL-40 levels were different between COPD and BA, with the measured values being significantly elevated. These patients exhibited distinct inflammatory profiles. Using the upper quartiles of these variables for the pooled study population (YKL-40: 5100 pg/mL; fibrinogen: 552 mg/dL) as cut-off values, subjects were classified into high or low groups. High YKL-40 adults revealed significantly increased PCT levels. High fibrinogen subjects, by contrast, showed significantly elevated IL-6 concentrations and pre-treatment CRP levels. Low YKL-40 and fibrinogen patients showed the absence of COPD. Combined use of serum YKL-40 and fibrinogen may be useful for identifying the absence of COPD.
支气管哮喘（BA）和慢性阻塞性肺疾病（COPD）不仅是常见的阻塞性呼吸道疾病，也是全球发病率和死亡率的主要原因。然而，用于区分这些肺部疾病的血液生物标志物却非常匮乏。本研究旨在评估血清 YKL-40 单独或联合使用在这方面的实际意义。
研究对象包括罗马尼亚的 BA 患者（n=24）和 COPD 患者（n=27）。测量并比较了 YKL-40、纤维蛋白原、治疗前 C 反应蛋白（CRP）、治疗后 CRP、红细胞沉降率、白细胞介素 6（IL-6）、降钙素原（PCT）、绝对中性粒细胞计数、中性粒细胞百分比、绝对淋巴细胞计数、淋巴细胞百分比、绝对嗜酸性粒细胞计数和嗜酸性粒细胞百分比。
这是首个研究在白种人群中调查血清 YKL-40 在区分 COPD 和 BA 中的临床意义的研究。只有纤维蛋白原和 YKL-40 水平在 COPD 和 BA 之间存在差异，测量值显著升高。这些患者表现出不同的炎症特征。使用这些变量的上四分位数（YKL-40：5100 pg/mL；纤维蛋白原：552 mg/dL）作为截断值，将患者分为高或低组。高 YKL-40 成人的 PCT 水平显著升高。相反，高纤维蛋白原组的 IL-6 浓度和治疗前 CRP 水平显著升高。低 YKL-40 和纤维蛋白原患者不存在 COPD。联合使用血清 YKL-40 和纤维蛋白原可能有助于识别 COPD 的缺失。
