Inflammation ( # 2014) DOI: 10.1007/s10753-014-0010-3
Pentraxin 3 as a Novel Biomarker of Inflammation in Chronic Obstructive Pulmonary Disease Ozlem Kar Kurt,1,3 Mehmet Tosun,2 Emine Bahar Kurt,1 and Fahrettin Talay1
Abstract—Chronic obstructive pulmonary disease (COPD) is a complex chronic inflammatory disease of the lungs in which inflammatory markers are involved with significant extrapulmonary effects that may contribute to its severity and complications. Moreover, some of the inflammatory markers such as C-reactive protein (CRP) are associated with COPD. Pentraxin 3 (PTX3) is the member of long pentraxins. The aim of the present study was to investigate the level of PTX3 in patients with COPD. Fifty-four COPD patients and 31 controls were enrolled in this study. Demographical data such as age, sex, cigarette smoking status, comorbidities, drugs, habits, and modified Medical Research Council (MMRC) dyspnea scores were recorded. All patients were asked for COPD Assessment Test™ (CAT). The mean age was 65.7±9.8 years, 92 % male. Plasma levels of PTX3 were found to be markedly higher in COPD patients [1.65 (0.32–12.72) ng/ml] than in controls [1.05 (0.43–3.26) ng/ml; p=0.005]. On the other hand, PTX3 values did not differ between COPD stages [A, 1.73 (0.69–11.03); B, 1.49 (0.84– 12.52); C, 0.79 (0.52–1.06); and D, 2.09 (0.32–12.72); p=0.27]. The plasma PTX3 levels were positively correlated with MMRC scores. We conclude that circulating PTX3 levels are elevated in COPD patients. Plasma levels of PTX3 were correlated with dyspnea (MMRC scores). But PTX3 levels were not correlated with the severity of COPD. KEY WORDS: pentraxin 3; chronic obstructive pulmonary disease; inflammation; dyspnea scores.
INTRODUCTION According to recent estimates, the prevalence of chronic obstructive pulmonary disease (COPD) is increasing and it is expected to become the third most important cause of death by 2020 . COPD is a preventable and treatable disease characterized by persistent airflow limitation that is usually progressive and associated with an enhanced chronic inflammatory response in the airways and lungs to noxious particles or gases especially cigarette smoke . It is a complex chronic inflammatory process of the lungs in which inflammatory markers are involved with significant extrapulmonary effects that may contribute to its severity and a number of 1
Department of Chest Diseases, Abant Izzet Baysal University Faculty of Medicine, 14280 Bolu, Turkey 2 Department of Biochemistry, Abant Izzet Baysal University Faculty of Medicine, Bolu, Turkey 3 To whom correspondence should be addressed at Department of Chest Diseases, Abant Izzet Baysal University Faculty of Medicine, 14280 Bolu, Turkey. E-mail: [email protected]
different complications [3, 4]. Moreover, some of the inflammatory markers such as C-reactive protein (CRP) are associated with COPD . Growing evidence suggests that elevated levels of CRP in COPD can predict adverse outcomes and the development of cardiovascular complications such as atherosclerosis . Also it was demonstrated to predict prognosis of COPD and diagnosis of acute exacerbations [7, 8]. Pentraxin 3 (PTX3) is the member of long pentraxins. It has been found to be produced rapidly both by hematopoietic cells and nonhematopoietic cells such as fibroblasts and vascular endothelial cells in response to inflammation . Serum PTX3 has been found to be elevated in patients with inflammatory conditions such as acute myocardial infarction [10, 11], unstable angina pectoris, sepsis , heart failure , and psoriasis . Van Pottelberge et al.  reported a significant positive correlation between plasma PTX3 levels and FEV1 in COPD subgroups. The aim of the present study was to investigate the level of PTX3 in patients with COPD and also to determine the association between plasma PTX3 and symptoms and severity of disease and parameters of airway obstruction.
0360-3997/14/0000-0001/0 # 2014 Springer Science+Business Media New York
Kurt, Tosun, Kurt, and Talay METHODS Patient Selection A total of 85 patients were prospectively recruited in this study from April 2012 to February 2013. The study was approved by the medical ethical committee of Abant Izzet Baysal University Hospital, Bolu, Turkey and all patients gave written informed consent. Fifty-four stable COPD patients and 31 controls were enrolled in this study. Patients with severe cardiovascular disease, diabetes mellitus, cerebrovascular disease, systemic infection, ventilator dependency, malignancy, hepatic cirrhosis, endstage renal disease, rheumatologic disorders, tuberculosis, neurological, or psychiatric illnesses that could interfere with the participation in the study, or any systemic infection or inflammatory process that could be associated with increased CRP or PTX3 concentrations were excluded. Demographical data such as age, sex, cigarette smoking status, comorbidities, drugs, and habits were recorded. All patients were asked for COPD Assessment Test™ (CAT). It consists of eight items scored from 0 (best) to 5 (worst) relating to coughing, mucus production, chest tightness, capacity for exercise and activities, confidence, sleep quality, and energy levels . The scaling range is from 0 to 40. The modified Medical Research Council (MMRC) scale was used to evaluate dyspnea in COPD patients. MMRC includes five grades (0–4) of various physiological activities that provoke dyspnea . Spirometry The inclusion criteria for the cases were a diagnosis of COPD with a forced expiratory volume in 1 s (FEV1)/ forced vital capacity (FVC) ratio