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Mucus plugging, disease severity and sputum myeloperoxidase concentration in bronchiectasis
Sun-Hyung Kim1,2, Ki Man Lee1,2, Jin Young Yoo3
1Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Chungbuk National University Hospital, Chungbuk National University College of Medicine, Cheongju, Republic of Korea.
Background:
Bronchiectasis is characterised by impaired mucociliary clearance, leading to persistent mucus accumulation, known as mucus plugging (MP). Myeloperoxidase (MPO) is a key molecule that activates neutrophilic inflammation during bronchiectasis, leading to disease progression. However, whether sputum MPO concentration is an independent factor associated with MP remains unclear.
Methods:
We retrospectively evaluated 78 patients with bronchiectasis at Chungbuk National University Hospital (Cheongju, Republic of Korea) between June 2022 and April 2023. According to the extent of MP on chest computed tomography, participants were divided into high MP (MP in >9 bronchopulmonary segments) and low MP (MP in ≤9 bronchopulmonary segments) groups. We evaluated whether sputum MPO concentration is independently associated with MP using multivariable adjusted logistic regression analyses.
Results:
There were 59 (75.6%) and 19 (24.4%) participants in the low and high MP groups, respectively. Compared with the low MP group, the high MP group had significantly higher disease severity, as measured by the modified Reiff score (p<0.001) and FACED score (p=0.003). Sputum MPO concentration was significantly correlated with the extent of MP (ρ=0.313, p=0.009). In addition, sputum MPO concentration was independently associated with a high extent of MP even after adjusting for potential confounders (adjusted OR 1.60 (95% CI 1.06-2.42)).
Conclusions:
Sputum MPO concentration was associated with a high degree of MP, suggesting a potential role of MPO in the pathogenesis of mucus plugging.
Insights
Sputum myeloperoxidase (MPO) concentration is linked to mucus plugging (MP) in bronchiectasis patients. Higher MPO levels independently predict extensive MP, suggesting MPO’s role in mucus plugging development.
Area of Science:
- Pulmonology
- Biochemistry
- Medical Diagnostics
Background:
- Bronchiectasis involves impaired mucociliary clearance, causing mucus accumulation (mucus plugging, MP).
- Myeloperoxidase (MPO) drives neutrophilic inflammation in bronchiectasis, potentially worsening the disease.
- The independent association between sputum MPO concentration and MP extent was previously unclear.
Purpose of the Study:
- To investigate if sputum myeloperoxidase (MPO) concentration is an independent predictor of mucus plugging (MP) in bronchiectasis patients.
- To determine the relationship between MPO levels and the severity of MP.
Main Methods:
- Retrospective study of 78 bronchiectasis patients.
- Classification into high MP (>9 segments) and low MP (≤9 segments) groups based on CT scans.
- Multivariable logistic regression analysis to assess the independent association of sputum MPO with MP extent.
Main Results:
- High MP group showed significantly greater disease severity (modified Reiff and FACED scores).
- Sputum MPO concentration positively correlated with MP extent (ρ=0.313, p=0.009).
- Sputum MPO concentration was independently associated with high MP extent (adjusted OR 1.60).
Conclusions:
- Sputum MPO concentration is significantly associated with a high degree of mucus plugging in bronchiectasis.
- MPO may play a role in the pathogenesis of mucus plugging in this condition.
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