Use of Biomarkers in Chronic Obstructive Pulmonary Disease: Clinical Implications

Lung function trajectory and biomarkers in the Tasmanian Longitudinal Health Study

“…Unfortunately, the uniqueness of TAHS makes it impossible to validate our observations in other cohorts. We acknowledge that our selection of biomarkers based on available data at the time the study was set up is a limitation, and exploration of other candidates using unbiased proteomics is warranted [21][22][23][24][25][26] and will occur with a future planned follow up. As we only had data on biomarkers at 45 and 53 years, having such data over time from childhood would have provided more information on the longitudinal association with lung function trajectories leading to COPD.…”

Enriched Systemic Biomarkers in Symptomatic Unobstructed Smokers

“…Indeed, plasma fibrinogen and CRP levels, singly or in combination with other molecules, do relate to risk of death. 7 The presence of abnormal levels of systemic biomarkers in asymptomatic unobstructed ever-smokers could relate to the remodeling of bronchioles, as supported by the significant decrease in terminal and transitional bronchioles in patients with mild-to-moderate COPD, with the remaining small airways showing airway wall thickening and luminal obstruction in lung regions not affected by emphysema. 8 Likewise, the data are consistent with the presence of endothelial dysfunction of small pulmonary arteries associated with thickened intima layers in smokers with normal spirometry, 9 therefore enhancing the vital pathogenic role of pulmonary vascular abnormalities in pregrade COPD.…”

“…6 A National Institutes of Health Working Group has defined biomarker as a "characteristic that is objectively measured and evaluated as an indicator of normal biological processes, pathogenic processes, or pharmacologic responses to therapeutic interventions." 7 Currently, other than lung function measurements and the controversial high levels of blood eosinophils to modulate the therapy of COPD, there are no established biomarkers to enhance and improve care for patients with COPD and their outcomes. Although most previous studies have been biased by small sample size, poorly defined clinical phenotypes, low performance, and lack of reproducibility and/or validation, it is encouraging to see that there are promising biomarkers in the future.…”