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Multiple biomarkers predict disease severity, progression and mortality in COPD.
Rachel L Zemans1,2, Sean Jacobson3, Jason Keene4
1Division of Pulmonary, Critical Care, and Sleep Medicine, Department of Medicine, National Jewish Health, 1400 Jackson St., Denver, CO, 80206, USA. zemansr@njhealth.org.
Respiratory Research
|June 15, 2017
Summary
Combining multiple blood biomarkers significantly improves prediction of chronic obstructive pulmonary disease (COPD) subtypes, severity, progression, and mortality compared to individual markers. This approach enhances understanding of COPD heterogeneity and outcomes.
Area of Science:
- Pulmonary Medicine
- Biomarker Discovery
- Chronic Obstructive Pulmonary Disease (COPD)
Background:
- Chronic obstructive pulmonary disease (COPD) is a complex, heterogeneous respiratory disease with variable progression and subtypes.
- Individual blood biomarkers have shown limited success in predicting COPD outcomes.
- The hypothesis posits that combined biomarkers offer superior predictive power for COPD characteristics and prognosis.
Purpose of the Study:
- To investigate whether combinations of plasma biomarkers are more predictive of COPD subtypes, severity, progression, and mortality than individual biomarkers.
- To validate findings across two independent large cohorts: COPDGene and ECLIPSE.
Main Methods:
- Plasma levels of Fibrinogen, C-Reactive Protein (CRP), surfactant protein D (SP-D), soluble Receptor for Advanced Glycation Endproducts (sRAGE), and Club Cell Secretory Protein (CC16) were measured.
- Regression analysis was employed to assess the predictive value of individual and combined biomarkers for COPD outcomes.
- Analyses were adjusted for clinical covariates in 1465 COPDGene subjects and 2746 ECLIPSE subjects.
Main Results:
- Biomarker combinations effectively predicted airflow limitation, emphysema presence, FEV1 decline, and emphysema progression in the COPDGene cohort.
- A combination of SP-D, CRP, and fibrinogen emerged as the strongest predictor of mortality in the ECLIPSE cohort and was validated in COPDGene.
- The predictive value of combined biomarkers surpassed that of individual biomarkers and clinical variables for various COPD outcomes.
Conclusions:
- Combinations of blood biomarkers significantly enhance the prediction of cross-sectional and longitudinal COPD outcomes.
- This multi-biomarker approach offers a more comprehensive understanding of COPD heterogeneity, progression, and mortality risk.
- Findings support the utility of multi-biomarker panels for improved COPD management and risk stratification.
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