Skip to main content
SpringerLink
Log in

Serum Cystatin C as an Inflammatory Marker in Exacerbated and Convalescent COPD Patients

  • ORIGINAL ARTICLE
  • Published:
Inflammation Aims and scope Submit manuscript

Abstract

Chronic obstructive pulmonary disease (COPD) is a common chronic inflammatory disease with high morbidity and mortality rates. Cystatin C (Cys C) is a sensitive indicator for various chronic inflammatory diseases. In this study, we aimed to evaluate the role of Cys C in COPD patients comparing with the other well-known inflammatory markers. Ninety patients with acute exacerbated COPD were studied and were reassessed when convalescent. Ninety controls were matched for age, gender, body mass index, smoking index, and comorbidity. Serum Cys C was significantly increased in convalescent COPD patients compared with healthy controls and further increased in COPD patients with an acute exacerbation. Serum Cys C was positively correlated with hsCRP both in the exacerbation and convalescence periods of COPD and negatively correlated with FEV1% predicted and FEV1/FVC in the convalescent COPD patients. In conclusion, serum Cys C is a positive acute-phase reactant in COPD patients and might indicate systemic inflammation during the progression of COPD.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2

Similar content being viewed by others

References

  1. Burney, P.G., J. Patel, R. Newson, C. Minelli, and M. Naghavi. 2015. Global and regional trends in COPD mortality, 1990-2010. European Respiratory Journal 45: 1239–1247.

    Article  PubMed  PubMed Central  Google Scholar 

  2. Fang, X., X. Wang, and C. Bai. 2011. COPD in China: the burden and importance of proper management. Chest 139: 920–929.

    Article  PubMed  Google Scholar 

  3. MacNee, W. 2013. Systemic inflammatory biomarkers and co-morbidities of chronic obstructive pulmonary disease. Annals of Medicine 45: 291–300.

    Article  CAS  PubMed  Google Scholar 

  4. Fischer, B.M., E. Pavlisko, and J.A. Voynow. 2011. Pathogenic triad in COPD: oxidative stress, protease-antiprotease imbalance, and inflammation. International Journal of Chronic Obstructive Pulmonary Disease 6: 413–421.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  5. Owen, C.A. 2008. Roles for proteinases in the pathogenesis of chronic obstructive pulmonary disease. International Journal of Chronic Obstructive Pulmonary Disease 3: 253–268.

    CAS  PubMed  PubMed Central  Google Scholar 

  6. Xu, Y., Y. Ding, X. Li, and X. Wu. 2015. Cystatin C is a disease-associated protein subject to multiple regulation. Immunology and Cell Biology 93: 442–451.

    Article  CAS  PubMed  Google Scholar 

  7. Rokadia, H.K., and S. Agarwal. 2012. Serum cystatin C and emphysema: results from the National Health and Nutrition Examination Survey (NHANES). Lung 190: 283–290.

    Article  CAS  PubMed  Google Scholar 

  8. Takeyabu, K., T. Betsuyaku, M. Nishimura, A. Yoshioka, M. Tanino, K. Miyamoto, et al. 1998. Cysteine proteinases and cystatin C in bronchoalveolar lavage fluid from subjects with subclinical emphysema. European Respiratory Journal 12: 1033–1039.

    Article  CAS  PubMed  Google Scholar 

  9. Werle, B., K. Sauckel, C.M. Nathanson, M. Bjarnadottir, E. Spiess, W. Ebert, et al. 2003. Cystatins C, E/M and F in human pleural fluids of patients with neoplastic and inflammatory lung disorders. Biological Chemistry 384: 281–287.

    Article  CAS  PubMed  Google Scholar 

  10. Lee, Y.T., S.C. Chen, L.Y. Shyu, M.C. Lee, T.C. Wu, S.M. Tsao, et al. 2012. Significant elevation of plasma cathepsin B and cystatin C in patients with community-acquired pneumonia. Clinica Chimica Acta 413: 630–635.

    Article  CAS  Google Scholar 

  11. Wang, G.N., K. Sun, D.L. Hu, H.H. Wu, X.Z. Wang, and J.S. Zhang. 2014. Serum cystatin C levels are associated with coronary artery disease and its severity. Clinical Biochemistry 47: 176–181.

    Article  CAS  PubMed  Google Scholar 

  12. Zhang, M., X. Cao, G. Cai, D. Wu, R. Wei, X. Yuan, et al. 2013. Clinical evaluation of serum cystatin C and creatinine in patients with chronic kidney disease: a meta-analysis. Journal of International Medical Research 41: 944–955.

    Article  CAS  PubMed  Google Scholar 

  13. Bateman, E.D., C. Feldman, J. O’Brien, M. Plit, J.R. Joubert, and Society CGWGotSAT. 2004. Guideline for the management of chronic obstructive pulmonary disease (COPD): 2004 revision. South African medical journal = Suid-Afrikaanse tydskrif vir geneeskunde 94: 559–575.

    CAS  PubMed  Google Scholar 

  14. Vestbo, J., S.S. Hurd, A.G. Agusti, P.W. Jones, C. Vogelmeier, A. Anzueto, et al. 2013. Global strategy for the diagnosis, management, and prevention of chronic obstructive pulmonary disease: GOLD executive summary. American Journal of Respiratory and Critical Care Medicine 187: 347–365.

    Article  CAS  PubMed  Google Scholar 

  15. Koutsokera, A., T.S. Kiropoulos, D.J. Nikoulis, Z.D. Daniil, V. Tsolaki, K. Tanou, et al. 2009. Clinical, functional and biochemical changes during recovery from COPD exacerbations. Respiratory Medicine 103: 919–926.

    Article  PubMed  Google Scholar 

  16. Levey, A.S., J.P. Bosch, J.B. Lewis, T. Greene, N. Rogers, and D. Roth. 1999. A more accurate method to estimate glomerular filtration rate from serum creatinine: a new prediction equation. Modification of Diet in Renal Disease Study Group. Annals of Internal Medicine 130: 461–470.

    Article  CAS  PubMed  Google Scholar 

  17. Mussap, M., and M. Plebani. 2004. Biochemistry and clinical role of human cystatin C. Critical Reviews in Clinical Laboratory Sciences 41: 467–550.

    Article  CAS  PubMed  Google Scholar 

  18. Vega, A., S. Garcia de Vinuesa, M. Goicoechea, U. Verdalles, M.L. Martinez-Pueyo, A. Chacon, et al. 2014. Evaluation of methods based on creatinine and cystatin C to estimate glomerular filtration rate in chronic kidney disease. International Urology and Nephrology 46: 1161–1167.

    Article  CAS  PubMed  Google Scholar 

  19. Angelidis, C., S. Deftereos, G. Giannopoulos, N. Anatoliotakis, G. Bouras, G. Hatzis, et al. 2013. Cystatin C: an emerging biomarker in cardiovascular disease. Current Topics in Medicinal Chemistry 13: 164–179.

    Article  CAS  PubMed  Google Scholar 

  20. Buczek-Thomas, J.A., E.C. Lucey, P.J. Stone, C.L. Chu, C.B. Rich, I. Carreras, et al. 2004. Elastase mediates the release of growth factors from lung in vivo. Am J Resp Cell Mol 31: 344–350.

    Article  CAS  Google Scholar 

  21. Solem, M., C. Rawson, K. Lindburg, and D. Barnes. 1990. Transforming growth factor beta regulates cystatin C in serum-free mouse embryo (SFME) cells. Biochemical and Biophysical Research Communications 172: 945–951.

    Article  CAS  PubMed  Google Scholar 

  22. Lalmanach, G., A. Saidi, S. Marchand-Adam, F. Lecaille, and M. Kasabova. 2015. Cysteine cathepsins and cystatins: from ancillary tasks to prominent status in lung diseases. Biological Chemistry 396: 111–130.

    Article  CAS  PubMed  Google Scholar 

  23. Leung-Tack, J., C. Tavera, M.C. Gensac, J. Martinez, and A. Colle. 1990. Modulation of phagocytosis-associated respiratory burst by human cystatin C: role of the N-terminal tetrapeptide Lys-Pro-Pro-Arg. Experimental Cell Research 188: 16–22.

    Article  CAS  PubMed  Google Scholar 

  24. Buttle, D.J., D. Burnett, and M. Abrahamson. 1990. Levels of neutrophil elastase and cathepsin B activities, and cystatins in human sputum: relationship to inflammation. Scandinavian Journal of Clinical and Laboratory Investigation 50: 509–516.

    Article  CAS  PubMed  Google Scholar 

  25. Sun, Q. 1989. Growth stimulation of 3T3 fibroblasts by cystatin. Experimental Cell Research 180: 150–160.

    Article  CAS  PubMed  Google Scholar 

  26. Cimerman, N., P.M. Brguljan, M. Krasovec, S. Suskovic, and J. Kos. 2000. Serum cystatin C, a potent inhibitor of cysteine proteinases, is elevated in asthmatic patients. Clinica Chimica Acta 300: 83–95.

    Article  CAS  Google Scholar 

  27. Shigemura, M., S. Konno, Y. Nasuhara, C. Shimizu, K. Matsuno, and M. Nishimura. 2012. Impact of asthmatic control status on serum cystatin C concentrations. Clinical Chemistry and Laboratory Medicine 50: 1367–1371.

    Article  CAS  PubMed  Google Scholar 

  28. Zhang, M., S.H. Fu, H. Cui, B.P. Zhu, L. Liu, and D.L. Wang. 2014. Serum cystatin C and indices of lung function in elderly Chinese men with chronic obstructive pulmonary disease. Aging Clinical and Experimental Research 26: 193–199.

    Article  PubMed  Google Scholar 

  29. Simpson, J.L., S. Phipps, and P.G. Gibson. 2009. Inflammatory mechanisms and treatment of obstructive airway diseases with neutrophilic bronchitis. Pharmacol Therapeut 124: 86–95.

    Article  CAS  Google Scholar 

  30. Stockley, R.A. 2009. Progression of chronic obstructive pulmonary disease: impact of inflammation, comorbidities and therapeutic intervention. Current Medical Research and Opinion 25: 1235–1245.

    Article  PubMed  Google Scholar 

  31. Moberg, M., J. Vestbo, G. Martinez, P. Lange, and T. Ringbaek. 2014. Prognostic value of C-reactive protein, leukocytes, and vitamin d in severe chronic obstructive pulmonary disease. Scientific World Journal 2014: 140736.

    Article  PubMed  PubMed Central  Google Scholar 

  32. Karadeniz, G., G. Polat, G. Senol, and M. Buyuksirin. 2013. C-reactive protein measurements as a marker of the severity of chronic obstructive pulmonary disease exacerbations. Inflammation 36: 948–953.

    Article  CAS  PubMed  Google Scholar 

Download references

Acknowledgments

This study was supported by grants from the Fundamental Research Funds for the Central Universities of China (No. xjj2015030 to M. Zhang) and the Youth Funds of the Second Affiliated Hospital of Xi’an Jiaotong University (No. YJ(QN)201410 to M. Zhang).

Author information

Authors and Affiliations

  1. Department of Respiratory Medicine, the Second Affiliated Hospital of Xi’an Jiaotong University, No. 157 West Fifth Road, Xi’an, Shaanxi, 710004, China

    Ming Zhang, Yali Li, Xia Yang, Hu Shan, Qiuhong Zhang, Zongjuan Ming, Yingying Xie, Haijuan Chen, Yanqin Liu & Jie Zhang

Authors
  1. Ming Zhang
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Yali Li
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Xia Yang
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Hu Shan
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Qiuhong Zhang
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Zongjuan Ming
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Yingying Xie
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. Haijuan Chen
    View author publications

    You can also search for this author in PubMed Google Scholar

  9. Yanqin Liu
    View author publications

    You can also search for this author in PubMed Google Scholar

  10. Jie Zhang
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Jie Zhang.

Ethics declarations

All participants gave informed consent. The study protocol was approved by the Research Committee of Human Investigation of Medical College of Xi’an Jiaotong University.

Conflict of Interest

The authors declare that they have no competing interests.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Zhang, M., Li, Y., Yang, X. et al. Serum Cystatin C as an Inflammatory Marker in Exacerbated and Convalescent COPD Patients. Inflammation 39, 625–631 (2016). https://doi.org/10.1007/s10753-015-0287-x

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10753-015-0287-x

KEY WORDS

Search

Navigation