Value of procalcitonin, C-reactive protein, and neopterin in exacerbations of chronic obstructive pulmonary disease
Lacoma, Alicia (Institut Germans Trias i Pujol. Hospital Universitari Germans Trias i Pujol)
Prat i Aymerich, Cristina (Institut Germans Trias i Pujol. Hospital Universitari Germans Trias i Pujol)
Andreo García, Felipe (Universitat Autònoma de Barcelona. Departament de Medicina)
Lores, Luis (Hospital de Sant Boi, Sant Boi de Llobregat)
Ruiz Manzano, J.. (Institut Germans Trias i Pujol. Hospital Universitari Germans Trias i Pujol)
Ausina, Vicente (Institut Germans Trias i Pujol. Hospital Universitari Germans Trias i Pujol)
Domínguez, José (Institut Germans Trias i Pujol. Hospital Universitari Germans Trias i Pujol)

Fecha:	2011
Resumen:	The identification of biological markers in order to assess different aspects of COPD is an area of growing interest. The objective of this study was to investigate whether levels of procalcitonin (PCT), C-reactive protein (CRP), and neopterin in COPD patients could be useful in identifying the etiological origin of the exacerbation and assessing its prognosis. We included 318 consecutive COPD patients: 46 in a stable phase, 217 undergoing an exacerbation, and 55 with pneumonia. A serum sample was collected from each patient at the time of being included in the study. A second sample was also collected 1 month later from 23 patients in the exacerbation group. We compared the characteristics, biomarker levels, microbiological findings, and prognosis in each patient group. PCT and CRP were measured using an immunofluorescence assay. Neopterin levels were measured using a competitive immunoassay. PCT and CRP showed significant differences among the three patient groups, being higher in patients with pneumonia, followed by patients with exacerbation (P < 0. 0001). For the 23 patients with paired samples, PCT and CRP levels decreased 1 month after the exacerbation episode, while neopterin increased. Neopterin showed significantly lower levels in exacerbations with isolation of pathogenic bacteria, but no differences were found for PCT and CRP. No significant differences were found when comparing biomarker levels according to the Gram result: PCT (P = 0. 191), CRP (P = 0. 080), and neopterin (P = 0. 109). However, median values of PCT and CRP were high for Streptococcus pneumoniae, Staphylococcus aureus, and enterobacteria. All biomarkers were higher in patients who died within 1 month after the sample collection than in patients who died later on. According to our results, biomarker levels vary depending on the clinical status. However, the identification of the etiology of infectious exacerbation by means of circulating biomarkers is encouraging, but its main disadvantage is the absence of a microbiological gold standard, to definitively demonstrate their value. High biomarker levels during an exacerbation episode correlate with the short-term prognosis, and therefore their measurement can be useful for COPD management.
Ayudas:	Instituto de Salud Carlos III CP03/00112
Derechos:	Aquest document està subjecte a una llicència d'ús Creative Commons. Es permet la reproducció total o parcial, la distribució, la comunicació pública de l'obra i la creació d'obres derivades, sempre que no sigui amb finalitats comercials, i sempre que es reconegui l'autoria de l'obra original.
Lengua:	Anglès
Documento:	Article ; recerca ; Versió publicada
Publicado en:	International journal of COPD, Vol. 6 (february 2011) , p. 157-169, ISSN 1178-2005

DOI: 10.2147/COPD.S16070
PMID: 21468168

13 p, 336.9 KB

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Documentos de investigación > Documentos de los grupos de investigación de la UAB > Centros y grupos de investigación (producción científica) > Ciencias de la salud y biociencias > Institut d'Investigació en Ciencies de la Salut Germans Trias i Pujol (IGTP)
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