Soluble urokinase-type plasminogen activator receptor as a measure of treatment response in acute exacerbation of COPD

Abstract

Objective:To evaluate the value of soluble urokinase-type plasminogen activator receptor (suPAR) in the diagnosis of acute exacerbation of COPD (AECOPD) and in monitoring treatment response, analyzing the relationship between suPAR and fibrinogen in AECOPD. AECOPD leads to increased airway inflammation, contributing to an exaggerated release of inflammatory mediators. Methods:We recruited 45 patients with AECOPD and 20 healthy control subjects. Medical histories were taken, and all subjects underwent clinical examination, chest X-ray, pulmonary function tests, and blood gas analysis. On day 1 (treatment initiation for the AECOPD patients) and day 14 (end of treatment), blood samples were collected for the determination of serum suPAR and plasma fibrinogen. Results:Serum levels of suPAR were significantly higher in the AECOPD group than in the control group. In the AECOPD patients, there was a significant post-treatment decrease in the mean serum suPAR level. The sensitivity, specificity, and accuracy of suPAR were 95.6%, 80.0%, and 93.0%, respectively. The Global Initiative for Chronic Obstructive Lung Disease stage (i.e., COPD severity) correlated positively and significantly with serum levels of suPAR and plasma levels of fibrinogen. Conclusions:Monitoring the serum suPAR level can be helpful in the evaluation of the COPD treatment response and might be a valuable biomarker for determining the prognosis of AECOPD. Because serum suPAR correlated with plasma fibrinogen, both markers could be predictive of AECOPD.

Serum biomarkers in patients with stable and exacerbated COPD‐bronchiectasis overlap syndrome

“…Among the studies performed in exacerbation period, Gümüş et al 36 showed that fibrinogen, CRP and suPAR levels were significantly higher in COPD exacerbated patients compare to healthy controls, and a negative correlation between suPAR and FEV 1 . In a similar study by AboEl‐Magd et al 37 showed higher serum suPAR level in patients with COPD exacerbation compared to healthy group, and decreasing suPAR levels after effective treatment for exacerbation. The study done by Godtfredsen NS et al supports the value of suPAR as a marker of poor prognosis, showing that increasing suPAR levels independently predicts the 30‐day mortality in a large group of acutely admitted patients with COPD 38 …”

“…There are few studies in the literature investigating the role of suPAR and PAI‐1 in the pathogenesis of COPD 31‐38 . In stable COPD patients, Wang et al 31 found that serum PAI‐1 levels were significantly higher and suPAR levels were similar compared to healthy people.…”

Soluble Urokinase-Type Plasminogen Activator Receptor and Arterial Stiffness in Patients with COPD

“…Circulating suPAR levels have been determined in COPD only by a few studies [ 12 – 15 ]. Two studies analysed suPAR during acute exacerbations [ 12 , 13 ]. These events are associated with airway and systemic inflammatory responses, and not surprisingly elevated suPAR levels were found during exacerbations [ 12 , 13 ].…”

“…Two studies analysed suPAR during acute exacerbations [ 12 , 13 ]. These events are associated with airway and systemic inflammatory responses, and not surprisingly elevated suPAR levels were found during exacerbations [ 12 , 13 ]. The results in stable disease are contradictory, as both higher [ 14 ] and similar [ 15 ] levels were found.…”

“…So far, only few studies have investigated suPAR in COPD, mainly focusing on acute exacerbations and reporting elevated levels [ 12 , 13 ]. In stable disease, Can et al reported higher serum suPAR levels compared to controls [ 14 ].…”