Pulmonary biomarkers in COPD exacerbations: a systematic review

Respiratory Research

Jean-William Fitting¹  Laurent P Nicod¹  Konstantinos Kostikas²  Angela Koutsokera³ 

[1] Department of Respiratory Medicine, University Hospital of Lausanne, Lausanne, Switzerland;2nd Respiratory Medicine Department, University of Athens Medical School, Attikon Hospital, Athens, Greece;Service de Pneumologie, Centre Hospitalier Universitaire Vaudois, Rue du Bugnon 46, 1011 Lausanne, Switzerland

关键词: Bronchoalveolar lavage;    Fractional exhaled nitric oxide;    Exhaled breath condensate;    Induced sputum;    Spontaneous sputum;    Cytokines;    Airway inflammation;    Biomarkers;    Exacerbations of COPD;    COPD (chronic obstructive pulmonary disease);   

Others  :  792491
DOI  :  10.1186/1465-9921-14-111

 received in 2013-07-25, accepted in 2013-10-07,  发布年份 2013

【 摘 要 】

Exacerbations of COPD (ECOPD) represent a major burden for patients and health care systems. Innovative sampling techniques have led to the identification of several pulmonary biomarkers. Although some molecules are promising, their usefulness in clinical practice is not yet established. Medline and Highwire databases were used to identify studies evaluating pulmonary sampled biomarkers in ECOPD. We combined 3 terms for ECOPD, 3 for biomarkers and 6 for the sampling method. Seventy-nine studies were considered eligible for inclusion in the review and were analyzed further. Pulmonary biomarkers sampled with non-invasive, semi-invasive and invasive methods were evaluated for their potential to illustrate the disease’s clinical course, to correlate to clinical variables and to predict clinical outcomes, ECOPD etiology and response to treatment. According to published data several pulmonary biomarkers assessed in ECOPD have the potential to illustrate the natural history of disease through the modification of their levels. Among the clinically relevant molecules, those that have been studied the most and appear to be promising are spontaneous and induced sputum biomarkers for reflecting clinical severity and symptomatic recovery, as well as for directing towards an etiological diagnosis. Current evidence on the clinical usefulness of exhaled breath condensate and bronchoalveolar lavage biomarkers in ECOPD is limited. In conclusion, pulmonary biomarkers have the potential to provide information on the mechanisms underlying ECOPD, and several correlate with clinical variables and outcomes. However, on the basis of published evidence, no single molecule is adequately validated for wide clinical use. Clinical trials that incorporate biomarkers in decisional algorithms are required.

【 授权许可】

   
2013 Koutsokera et al.; licensee BioMed Central Ltd.

【 图 表 】

Figure 1.

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