Chatziantoniou Argyro, Karagiannis Konstantinos, Mathioudakis Alexander G, Tsitoura Eliza, Synolaki Eugenia, Apostolou Eirini, Sideras Paschalis, Tzanakis Nikolaos, Siafakas Nikolaos M, Antoniou Katerina M
Department of Respiratory Medicine, University Hospital of Heraklion, Heraklion, Greece.
Laboratory of Molecular and Cellular Pneumonology, School of Medicine, University of Crete, Heraklion, Greece.
In Vivo. 2025 Sep-Oct;39(5):2573-2583. doi: 10.21873/invivo.14058.
BACKGROUND/AIM: Chronic airway diseases, including chronic obstructive pulmonary disease (COPD), asthma, and asthma COPD overlap (ACO), are characterized by complex inflammatory processes in which Activin A-a key member of the TGF-β superfamily-is implicated. Although its role in the stable state of these diseases has been extensively studied, data regarding its involvement during exacerbations remain limited. Our objective was to investigate the dynamics of Activin A in sputum and serum during acute exacerbations and subsequent convalescence in patients with chronic airway diseases.
In this prospective study, 53 patients with asthma, COPD, and ACO, aged 14 years and older were recruited upon hospitalization for an acute exacerbation. Sputum and peripheral blood samples were collected at admission, hospital discharge, one month, and four months post-exacerbation. Protein levels of Activin A were quantified by ELISA were compared among the patient groups and the kinetics of Activin A expression following exacerbation events were examined.
Baseline Activin A levels were comparable across the patient groups. However, during exacerbations, sputum Activin A levels increased markedly and subsequently declined during convalescence, while serum levels exhibited an inverse pattern-being lower during exacerbations and rising during stable periods. Notably, COPD patients with recurrent exacerbations maintained persistently elevated sputum Activin A levels throughout the study period, suggesting that sustained local inflammation may predispose these patients to frequent exacerbations.
These findings reveal a compartment-specific regulation of Activin A in chronic airway diseases, underscoring its potential as a biomarker for disease activity and exacerbation risk.
背景/目的：慢性气道疾病，包括慢性阻塞性肺疾病（COPD）、哮喘以及哮喘-COPD重叠综合征（ACO），其特征为复杂的炎症过程，而激活素A（转化生长因子-β超家族的关键成员）参与其中。尽管其在这些疾病稳定期的作用已得到广泛研究，但关于其在病情加重期间的作用的数据仍然有限。我们的目的是研究慢性气道疾病患者急性加重期及随后恢复期痰液和血清中激活素A的动态变化。
在这项前瞻性研究中，招募了53例年龄在14岁及以上的哮喘、COPD和ACO患者，他们因急性加重而住院。在入院时、出院时、病情加重后1个月和4个月采集痰液和外周血样本。通过酶联免疫吸附测定法（ELISA）对激活素A的蛋白质水平进行定量，并在患者组之间进行比较，同时检查病情加重事件后激活素A表达的动力学变化。
各患者组的激活素A基线水平相当。然而，在病情加重期间，痰液中激活素A水平显著升高，随后在恢复期下降，而血清水平则呈现相反的模式——在病情加重期间较低，在稳定期升高。值得注意的是，反复病情加重的COPD患者在整个研究期间痰液中激活素A水平持续升高，这表明持续的局部炎症可能使这些患者易患频繁的病情加重。
这些发现揭示了慢性气道疾病中激活素A的特定隔室调节，强调了其作为疾病活动和病情加重风险生物标志物的潜力。
