Liu Ming-Yan, Qu Kai-Xin, Ma Kai-Shu, Cheng Zhen-Yu, Cai Xiang, Miu Hai-Long, Liu Meng-Xue, Wang Yi-Qun, Zhao Hui, Zheng Ling, Fu Lin, Yang Jin
Department of Respiratory and Critical Care Medicine, The Second Affiliated Hospital of Anhui Medical University, Hefei, 230601, Anhui, China.
Institute of Respiratory Diseases, The Second Affiliated Hospital of Anhui Medical University, Hefei, 230601, Anhui, China.
Lung. 2025 Aug 11;203(1):87. doi: 10.1007/s00408-025-00841-3.
Cytokeratin (CK)18 is present in the bronchi and alveolar epithelium of the lung, and its cleavage product, CK-18M30, serves as a biological marker of apoptosis. However, the specific roles of CK-18 and CK-18M30 in acute exacerbation of chronic obstructive pulmonary disease (AECOPD) remain unclear.
This study enrolled 289 patients with AECOPD who met the inclusion criteria. Demographic information and clinical characteristics of the patients were documented. A 3-year follow-up period was implemented to evaluate acute exacerbations and mortality. Serum CK-18 and CK-18M30 concentrations were measured using enzyme-linked immunosorbent assays.
Serum concentrations of CK-18/CK-18M30 at admission in patients with AECOPD were higher than those in the control group. As severity increased, serum CK-18/CK-18M30 levels increased progressively in AECOPD patients. Pearson's correlation analysis revealed that serum CK-18/CK-18M30 concentrations were positively correlated with several clinical parameters. Linear and logistic regression models demonstrated positive correlations between serum CK-18 and CK-18M30 levels at admission and severity scores. Furthermore, higher serum CK-18/CK-18M30 levels at admission were associated with increased frequency of death and acute exacerbation in patients with AECOPD within 3 years.
Serum CK-18/CK-18M30 levels at admission were positively correlated with severity and poor prognosis in patients with AECOPD within 3 years. Therefore, serum CK-18 and CK-18M30 concentrations may serve as novel diagnostic and prognostic biomarkers for patients with AECOPD.
细胞角蛋白（CK）18存在于肺的支气管和肺泡上皮中，其裂解产物CK - 18M30可作为细胞凋亡的生物标志物。然而，CK - 18和CK - 18M30在慢性阻塞性肺疾病急性加重期（AECOPD）中的具体作用仍不清楚。
本研究纳入了289例符合纳入标准的AECOPD患者。记录患者的人口统计学信息和临床特征。实施3年随访期以评估急性加重情况和死亡率。采用酶联免疫吸附测定法测量血清CK - 18和CK - 18M30浓度。
AECOPD患者入院时血清CK - 18/CK - 18M30浓度高于对照组。随着病情严重程度增加，AECOPD患者血清CK - 18/CK - 18M30水平逐渐升高。Pearson相关性分析显示，血清CK - 18/CK - 18M30浓度与多个临床参数呈正相关。线性和逻辑回归模型表明，入院时血清CK - 18和CK - 18M30水平与严重程度评分呈正相关。此外，入院时较高的血清CK - 18/CK - 18M30水平与AECOPD患者3年内死亡和急性加重频率增加相关。
入院时血清CK - 18/CK - 18M30水平与AECOPD患者3年内的病情严重程度和不良预后呈正相关。因此，血清CK - 18和CK - 18M30浓度可能作为AECOPD患者新的诊断和预后生物标志物。
