Int J Chron Obstruct Pulmon Dis. 2016 Sep 07;11:2117-2123. doi: 10.2147/COPD.S113647. eCollection 2016.

Inflammatory biomarkers in asthma-COPD overlap syndrome.

International journal of chronic obstructive pulmonary disease

Seiichi Kobayashi, Masakazu Hanagama, Shinsuke Yamanda, Masatsugu Ishida, Masaru Yanai

PMID: 27660429 PMCID: PMC5021052 DOI: 10.2147/COPD.S113647

Abstract

BACKGROUND: The clinical phenotypes and underlying mechanisms of asthma-COPD overlap syndrome (ACOS) remain elusive. This study aimed to investigate a comparison of COPD patients with and without ACOS, focusing on inflammatory biomarkers, in an outpatient COPD cohort.

METHODS: We conducted a cross-sectional study analyzing prospectively collected data from the Ishinomaki COPD Network registry. All participants were diagnosed with COPD, confirmed by using spirometry, and were aged 40-90 years and former smokers. Patients with features of asthma including both variable respiratory symptoms and variable expiratory airflow limitation were identified and defined as having ACOS. Then, the inflammatory biomarkers such as fractional exhaled nitric oxide level, blood eosinophil count and percentage, total immunoglobulin E (IgE) level, and presence of antigen-specific IgE were evaluated.

RESULTS: A total of 257 patients with COPD were identified, including 37 (14.4%) with ACOS. Patients with ACOS tended to be younger, have a shorter smoking history, and use more respiratory medications, especially inhaled corticosteroids and theophylline. Mean fractional exhaled nitric oxide level was significantly higher in those with ACOS than in those without ACOS (38.5 parts per billion [ppb] vs 20.3 ppb,

CONCLUSION: These results provide evidence that these inflammatory biomarkers can be used to support the diagnosis of ACOS.

Keywords: COPD; asthma; asthma-COPD overlap syndrome; biomarkers

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