What Do Alpha-1 Antitrypsin Levels Tell Us About Chronic Inflammation in COPD?

doi:10.1016/j.arbres.2019.06.010

Archivos de Bronconeumología

Volume 56, Issue 2, February 2020, Pages 72-73

https://doi.org/10.1016/j.arbres.2019.06.010 Get rights and content

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Funding

No specific funding was received for this article. PRE is supported by a research grant from the Alpha 1 Foundation. AMT has current funding from the ATS Foundation, Alpha 1 Foundation, NIHR, Chiesi, AstraZeneca and CSL Behring

Conflict of interest

Alice Turner research grant received within the last 3 years from Grifols biotherapeutics and CSL Behring

References (16)

S. Janciauskiene et al.
Serum levels of alpha-1 antitrypsin deficiency and their relationship with COPD in the general Spanish population
Archivos de Bronconeumologia
(2020)
M. Thomsen et al.
Characteristics and outcomes of chronic obstructive pulmonary disease in never smokers in Denmark: a prospective population study
Lancet Respir Med
(2013)
W. Chen et al.
Risk of cardiovascular comorbidity in patients with chronic obstructive pulmonary disease: a systematic review and meta-analysis
Lancet Respir Med
(2015)
G. Brusselle et al.
Blood eosinophil levels as a biomarker in COPD
Respir Med
(2018)
D.A. Lomas
1-Antitrypsin deficiency * 4 molecular pathophysiology
Thorax
(2004)
R.G. Edgar et al.
Treatment of lung disease in alpha-1 antitrypsin deficiency: a systematic review
Int J Chron Obstruct Pulmon Dis
(2017)
M. Miravitlles et al.
European Respiratory Society statement: diagnosis and treatment of pulmonary disease in alpha1-antitrypsin deficiency
Eur Resp J
(2017)
C.P. Hersh et al.
Chronic obstructive pulmonary disease in alpha1-antitrypsin PI MZ heterozygotes: a meta-analysis
Thorax
(2004)

There are more references available in the full text version of this article.

Cited by (13)

Spanish Implementation of the New International Alpha-1 Anitrypsin Deficiency International Registry: The European Alpha-1 Research Collaboration (EARCO)
2021, Archivos de Bronconeumologia
Clinical and spirometric variables are better predictors of COPD exacerbations than routine blood biomarkers
2020, Respiratory Medicine
Citation Excerpt :
On the other hand, in this prospective analysis no significant relationship was found between exacerbations and blood eosinophil counts or EBR, which is consistent with other studies showing this lack of association, at least among patients with a low risk of exacerbations [16]. In summary, we could not identify any routine blood biomarker independently associated with future risk of exacerbations, which is consistent with the results of the SPIROMICS and COPDGene cohorts in which the biomarkers analysed added little to the predictive value of clinical covariates for exacerbations [26,36,37]. Finally, our results provide an equation of risk combining the three variables that were associated with risk of exacerbation.
Understanding the risk factors for exacerbations of COPD may help provide a more personalised approach to exacerbation prevention.
Observational, prospective, international, multicentre study aimed at identifying risk factors for exacerbations of COPD. Clinical variables, lung function and CAT scores were collected at baseline. In addition, routine blood biomarkers were also obtained, and patients were followed for 12 months.
A total of 326 patients were included. Of these, 155 (47.5%) presented at least one exacerbation. The median time to the first exacerbation was 147 days. Exacerbators had more respiratory symptoms, more impairment in FEV1(%), FVC(%) and a worse CAT score. Regarding biomarkers, only C-reactive protein was significantly higher in exacerbators (2.8 (standard deviation (SD):3.8) mg/dL vs. 1.9 (SD:2.6) mg/dL; p = 0.037). In multivariate analysis, only CAT scores, FEV1(%) and previous exacerbations were significantly associated with having an exacerbation during follow-up. In the equation of risk, patients with a CAT score ≥15, FEV1(%) <55% and at least one exacerbation the previous year had a probability of 76% of having an exacerbation during the next year, compared with 17% in patients who had none of the previous variables. No biomarkers showed a significant association in multivariate analysis.
Less than half of the patients presented an exacerbation during the one-year follow-up. CAT scores, FEV1(%) and previous exacerbations were the only variables associated with increased risk of exacerbations. Routine biomarkers did not provide additional information to evaluate the risk of exacerbations.
Biomarkers of chronic airflow limitation and COPD identified by mass spectrometry
2024, ERJ Open Research
Feasibility of a genotyping system for the diagnosis of alpha1 antitrypsin deficiency: a multinational cross-sectional analysis
2022, Respiratory Research
Association between circulating alpha-1 antitrypsin polymers and lung and liver disease
2021, Respiratory Research
Utility of transient elastography for the screening of liver disease in patients with alpha1-antitrypsin deficiency
2021, Journal of Clinical Medicine

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EditorialWhat Do Alpha-1 Antitrypsin Levels Tell Us About Chronic Inflammation in COPD?¿Qué nos dicen los niveles de alfa-1 antitripsina sobre la inflamación crónica en EPOC?

Section snippets

Funding

Conflict of interest

Archivos de Bronconeumologia

Lancet Respir Med

Lancet Respir Med

Respir Med

1-Antitrypsin deficiency * 4 molecular pathophysiology

Thorax

Treatment of lung disease in alpha-1 antitrypsin deficiency: a systematic review

Int J Chron Obstruct Pulmon Dis

European Respiratory Society statement: diagnosis and treatment of pulmonary disease in alpha1-antitrypsin deficiency

Eur Resp J

Chronic obstructive pulmonary disease in alpha1-antitrypsin PI MZ heterozygotes: a meta-analysis

Thorax

Editorial
What Do Alpha-1 Antitrypsin Levels Tell Us About Chronic Inflammation in COPD?¿Qué nos dicen los niveles de alfa-1 antitripsina sobre la inflamación crónica en EPOC?