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Updated: Feb 9, 2026
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Increased urinary l-histidine in patients with asthma-COPD overlap: a pilot study
Jee Youn Oh1, Young Seok Lee1, Kyung Hoon Min1
1Division of Pulmonary, Allergy and Critical Care Medicine, Department of Internal Medicine, Korea University Guro Hospital, Seoul, Republic of Korea.
Summary
Urinary l-histidine levels are elevated in patients with Asthma-COPD overlap (ACO), suggesting it could be a novel biomarker for diagnosing this complex respiratory condition. This finding aids in identifying ACO regardless of specific diagnostic criteria.
Area of Science:
- Respiratory Medicine
- Biomarker Discovery
- Metabolomics
Background:
- Asthma-COPD overlap (ACO) presents a diagnostic challenge due to its heterogeneous nature.
- A unified diagnostic approach is crucial for effective management of ACO.
- Histamine, involved in inflammatory responses, is linked to respiratory conditions.
Purpose of the Study:
- To investigate urinary l-histidine levels as a potential diagnostic biomarker for Asthma-COPD overlap (ACO).
- To explore the utility of l-histidine in differentiating ACO from asthma and COPD.
Main Methods:
- A prospective multicenter cohort study involving 107 patients categorized into asthma, COPD, and ACO groups.
- Urinary l-histidine levels were quantified using liquid chromatography-mass spectrometry.
- High-resolution metabolomic and multivariate statistical analyses were employed to distinguish metabolic profiles.
Main Results:
- Urinary l-histidine levels were significantly higher in ACO patients compared to asthma or COPD patients.
- Elevated urinary l-histidine was a significant diagnostic factor for ACO, independent of age, sex, and smoking status.
- Specific clinical indicators in airflow obstruction patients correlated with higher urinary l-histidine.
Conclusions:
- Urinary l-histidine shows promise as a potential biomarker for diagnosing ACO.
- This biomarker may be valuable across various diagnostic definitions of ACO.
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