Journal article
Systemic Markers of Inflammation in Smokers With Symptoms Despite Preserved Spirometry in SPIROMICS
Chest, Vol.155(5), pp.908-917
05/2019
DOI: 10.1016/j.chest.2018.12.022
PMCID: PMC6533449
PMID: 30684474
Abstract
Chronic respiratory symptoms and exacerbation-like events are common among ever-smokers without airflow limitation on spirometry. The pathobiology of respiratory disease in this subgroup remains poorly defined, but may be due to underlying inflammation that overlaps with COPD or asthma. We hypothesized that symptoms, exacerbations, and functional measures of disease severity among smokers with preserved spirometry would be associated with markers of systemic inflammation, similar to what is reported in bone fide COPD, rather than elevated type 2 inflammation, which is often present in asthma.
We measured inflammatory markers associated with COPD (C-reactive protein [CRP], fibrinogen, soluble tumor necrosis factor receptors [sTNFRSF1A and sTNFRSF1B], and blood/sputum neutrophils) and type 2 inflammation (IgE and blood/sputum eosinophils) in smokers with preserved spirometry (postbronchodilator FEV1/FVC ≥ 0.70) from the Subpopulations and Intermediate Outcome Measures In COPD Study (SPIROMICS). We evaluated the relationship of these markers with respiratory symptom burden (dichotomized by a COPD assessment test score cutoff of 10, diagnosis of chronic bronchitis), exacerbations, 6-minute walk distance, and lung function on the basis of FEV1.
CRP was associated with increased symptom burden (on the basis of COPD assessment test score and diagnosis of chronic bronchitis) and a greater number of exacerbations in the year before study enrollment. sTNFRSF1A was associated with symptom burden on the basis of COPD assessment test score. CRP and sTNFRSF1A levels negatively correlated with 6-minute walk distance. IgE and eosinophils were not associated with these outcomes.
Markers of inflammation including CRP and sTNFRSF1A are enriched among symptomatic smokers with preserved spirometry, suggesting an overlap with the underlying pathophysiology of COPD.
Details
- Title: Subtitle
- Systemic Markers of Inflammation in Smokers With Symptoms Despite Preserved Spirometry in SPIROMICS
- Creators
- Suresh Garudadri - Cleveland Clinic Lerner College of MedicinePrescott G. Woodruff - University of California, San FranciscoMeiLan K. Han - University of MichiganJeffrey L. Curtis - University of MichiganR. Graham Barr - Columbia UniversityEugene R. Bleecker - University of ArizonaRussell P. Bowler - National Jewish HealthAlejandro Comellas - University of IowaChristopher B. Cooper - University of California, Los AngelesGerard Criner - Temple UniversityMark T. Dransfield - University of Alabama at BirminghamNadia N. Hansel - Johns Hopkins UniversityRobert Paine - University of UtahJerry A. Krishnan - University of Illinois ChicagoStephen P. Peters - Wake Forest UniversityAnnette T. Hastie - Wake Forest UniversityFernando J. Martinez - Cornell UniversityWanda K. O'Neal - University of North Carolina at Chapel HillDavid J. Couper - University of North Carolina at Chapel HillNeil E. Alexis - University of North Carolina at Chapel HillStephanie A. Christenson - University of California, San Francisco
- Resource Type
- Journal article
- Publication Details
- Chest, Vol.155(5), pp.908-917
- DOI
- 10.1016/j.chest.2018.12.022
- PMID
- 30684474
- PMCID
- PMC6533449
- NLM abbreviation
- Chest
- ISSN
- 0012-3692
- eISSN
- 1931-3543
- Publisher
- Elsevier Inc
- Grant note
- HHSN268200900013C; HHSN268200900014C; HHSN268200900015C; HHSN268200900016C; HHSN268200900017C; HHSN268200900018C; HHSN268200900019C; HHSN268200900020C / National Institutes of Health (https://doi.org/10.13039/100000002)
- Language
- English
- Date published
- 05/2019
- Academic Unit
- Pulmonary, Critical Care, and Occupational Medicine; ICTS; Internal Medicine
- Record Identifier
- 9984359913102771
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