Inflammatory Serum Biomarker Pattern in Emphysema and Chronic Bronchitis Phenotypes of Acute Exacerbation of Chronic Obstructive Pulmonary Disease

Chronic Obstructive Pulmonary Disease (COPD) exacerbation is characterized by both airway and systemic inflammation. The present study aimed to investigate the relationship between serum levels of some inflammatory biomarkers and the phenotypes of COPD exacerbation.
This study includes known COPD patients, presenting to a hospital with acute exacerbation of COPD. Serum levels of CRP, ESR, CBC, TNF-α, IL-8, and IL-6 were measured at the time of admission. According to the previously done HRCT, the patients were divided into two groups including emphysema and chronic bronchitis. Levels of serum biomarkers were compared in the two groups. The relationships between biomarkers and duration of hospitalization were assessed too.
  Comparison of quantitative CRP levels, WBC, and platelet counts did not show a statistically significant difference between emphysema and chronic bronchitis but it was significantly higher than control subjects. Although not statistically significant, ESR level was higher in emphysema. TNF-alpha was 6.0±1.5 ng / ml and 1.5 ng / ml in the emphysema and chronic bronchitis groups, respectively. TNF-α had no significant difference compared to the groups. Although higher than the control group, IL-6 and IL-8 did not show significant differences between emphysema and chronic bronchitis. The two groups did not statistically differ in terms of hospital stay but patients with higher serum TNF-α tended to have longer hospitalization and ICU admission. The present study showed predictably higher inflammatory biomarkers in COPD exacerbation but no significant difference between the two phenotypes of COPD and these two entities could not be discriminated based on inflammatory bio-factors.