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Serum Surfactant Protein Levels in Patients Admitted to the Hospital with Acute COPD Exacerbation

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Abstract

Surfactant proteins (SPs) have been studied in COPD patients as biomarkers of disease severity and as predictive factors of unfavorable outcomes. The aim of this exploratory study was to evaluate serum levels of SP-A, SP-B, SP-C, and SP-D in patients with COPD both during AECOPD and in stability and to test their possible associations with disease severity and with the development of new exacerbation events. 20 consecutive COPD patients hospitalized for AECOPD were included. Serum SP levels were measured on admission, at discharge, and on stability. SP-A levels were significantly lower both on admission and at discharge in patients with early relapse compared to those with late or no relapse (29.2 ± 9.1 vs. 43.9 ± 16.9 ng/ml, p = 0.037, and 24.3 ± 2.8 vs. 39.3 ± 14.2 ng/ml, p = 0.011, respectively). SP-B levels were found to have a trend to be higher at discharge and significantly higher on stability in patients experiencing an early relapse compared to those with late or no relapse (52.5 ± 31.6 vs. 31.4 ± 32.3 ng/ml, p = 0.052 and 64.8 ± 32.6 vs. 32.8 ± 25.6 ng/ml, p = 0.024, respectively). Finally, the ROC analysis showed that serum SP-A, SP-B, and SP-C levels at discharge, seemed to be significant predictors of early relapse. Our conclusion is that serum levels of SPs might be related to disease outcomes in COPD patients.

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References

  1. Global Strategy for the Diagnosis, Management and Prevention of COPD, Global Initiative for Chronic Obstructive Lung Disease (GOLD) (2017). http://www.goldcopd.org. Accessed 12 July 2017

  2. Devendra G, Spragg RG (2002) Lung surfactant in subacute pulmonary disease. Respir Res 3:19

    Article  PubMed  PubMed Central  Google Scholar 

  3. Akella A, Deshpande SB (2013) Pulmonary surfactants and their role in pathophysiology of lung disorders. Indian J Exp Biol 51(1):5–22

    CAS  PubMed  Google Scholar 

  4. Whitsett JA, Wert SE, Weaver TE (2010) Alveolar surfactant homeostasis and the pathogenesis of pulmonary disease. Annu Rev Med 61:105–119

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  5. Sin DD, Leung R, Gan WQ et al (2007) Circulating surfactant protein D as a potential lung-specific biomarker of health outcomes in COPD: a pilot study. BMC Pulm Med 7:13

    Article  PubMed  PubMed Central  Google Scholar 

  6. Ozyurek BA, Ulasli SS, Bozbas SS et al (2013) Value of serum and induced sputum surfactant protein-D in chronic obstructive pulmonary disease. Multidiscip Respir Med 8(1):36

    Article  PubMed  PubMed Central  Google Scholar 

  7. Lomas DA, Silverman EK, Edwards LD et al (2009) Serum surfactant protein D is steroid sensitive and associated with exacerbations of COPD. Eur Respir J 34(1):95–102

    Article  CAS  PubMed  Google Scholar 

  8. Dickens JA, Miller BE, Edwards LD et al (2011) COPD association and repeatability of blood biomarkers in the ECLIPSE cohort. Respir Res 12:146

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  9. Baekvad-Hansen M, Nordestgaard BG, Dahl M (2011) Surfactant protein B polymorphisms, pulmonary function and COPD in 10,231 individuals. Eur Respir J 37(4):791–799

    Article  CAS  PubMed  Google Scholar 

  10. Baekvad-Hansen M, Nordestgaard BG, Tybjaerg-Hansen A et al (2010) Two novel mutations in surfactant protein-C, lung function and obstructive lung disease. Respir Med 104(3):418–425

    Article  PubMed  Google Scholar 

  11. Vlachaki EM, Koutsopoulos AV, Tzanakis N et al (2010) Altered surfactant protein-A expression in type II pneumocytes in COPD. Chest 137(1):37–45

    Article  CAS  PubMed  Google Scholar 

  12. Miller M, Hankinson J, Brusasco V, Burgos F, Casaburi R, Coates A, Crapo R, Enright P, van der Grinten C, Gustafsson P (1995) Standardization of spirometry, 1994 update. American thoracic society. Am J Respir Crit Care Med 152(3):1107–1136

    Article  Google Scholar 

  13. Connolly MJ, Lowe D, Anstey K et al (2006) Admissions to hospital with exacerbations of chronic obstructive pulmonary disease: effect of age related factors and service organisation. Thorax 61(10):843–848

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  14. Mazur W, Toljamo T, Ohlmeier S et al (2011) Elevation of surfactant protein A in plasma and sputum in cigarette smokers. Eur Respir J 38(2):277–284

    Article  CAS  PubMed  Google Scholar 

  15. Hurst JR, Vestbo J, Anzueto A et al (2010) Susceptibility to exacerbation in chronic obstructive pulmonary disease. N Engl J Med 363(12):1128–1138

    Article  CAS  PubMed  Google Scholar 

  16. Wright JR (2005) Immunoregulatory functions of surfactant proteins. Nat Rev Immunol 5(1):58–68

    Article  CAS  PubMed  Google Scholar 

  17. Christmann U, Buechner-Maxwell VA, Witonsky SG et al (2009) Role of lung surfactant in respiratory disease: current knowledge in large animal medicine. J Vet Intern Med 23(2):227–242

    Article  CAS  PubMed  Google Scholar 

  18. Kostikas K, Bakakos P, Papiris S et al (2013) Systemic biomarkers in the evaluation and management of COPD patients: are we getting closer to clinical application? Curr Drug Targets 14(2):177–191

    Article  CAS  PubMed  Google Scholar 

  19. Liu W, Ju CR, Chen RC et al (2014) Role of serum and induced sputum surfactant protein D in predicting the response to treatment in chronic obstructive pulmonary disease. Exp Ther Med 8(4):1313–1317

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  20. Hirama N, Shibata Y, Otake K et al (2007) Increased surfactant protein-D and foamy macrophages in smoking-induced mouse emphysema. Respirology 12(2):191–201

    Article  PubMed  Google Scholar 

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Correspondence to Andriana I. Papaioannou.

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Konstantinos Kostikas is a Novartis employee. All other authors declare they have no conflict of interest related to the present manuscript.

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This article does not contain any studies with animals performed by any of the authors. All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

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Informed consent was obtained from all individual participants included in the study.

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Papaioannou, A.I., Konstantelou, E., Papaporfyriou, A. et al. Serum Surfactant Protein Levels in Patients Admitted to the Hospital with Acute COPD Exacerbation. Lung 196, 201–205 (2018). https://doi.org/10.1007/s00408-018-0099-5

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  • DOI: https://doi.org/10.1007/s00408-018-0099-5

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