The Value of Inflammatory Biomarkers in Differentiating Asthma-COPD Overlap from COPD

Overview

Journal Int J Chron Obstruct Pulmon Dis

Publisher Dove Medical Press

Specialty Pulmonary Medicine

Date 2020 Nov 27

PMID 33244228

Citations 13

Authors

Meng Li

Tian Yang

Ruiqing He

Anqi Li

Wenhui Dang

Xinyu Liu

Mingwei Chen

Affiliations

Soon will be listed here.

Abstract

Purpose: To evaluate the accuracy of inflammatory biomarkers in differentiating patients with asthma-COPD overlap (ACO) from those with COPD alone.

Methods: Clinical data of 134 patients with COPD and 48 patients with ACO admitted to the First Affiliated Hospital of Xi'an Jiaotong University from January 2016 to June 2019 were retrospectively analyzed. Receiver operating characteristic (ROC) curve analysis was performed to determine the best cut-off values of fractional exhaled nitric oxide (FeNO), blood eosinophil counts (EOS), and neutrophil to lymphocyte ratio (NLR) for differentiating between ACO and COPD alone. Spearman correlation analysis was conducted to evaluate the relationships between these inflammatory biomarkers and the forced expiratory volume in one second/prediction (FEV%pred).

Results: FeNO and EOS in the ACO patients were significantly higher than those in the COPD patients (FeNO: median 37.50 vs 24.50 ppb, < 0.001; EOS: median 0.20 vs 0.10 ×10/L, = 0.004). FeNO was positively correlated with FEV%pred (r = 0.314, = 0.030), while NLR was negatively correlated with FEV%pred (r = -0.372, = 0.009) in patients with ACO. In addition, a positive correlation between FeNO and EOS was also found in ACO, especially in patients without history of inhaled corticosteroids (ICS) use (r = 0.682, < 0.001). The optimal cut-off value of FeNO was 31.5 ppb (AUC = 0.758, 95% CI = 0.631-0.886) in patients with smoking history, with 70.0% sensitivity and 89.9% specificity for differentiating ACO from COPD. In patients without history of ICS use, the best cut-off value of FeNO was 39.5 ppb (AUC = 0.740, 95% CI = 0.610-0.870), with 58.3% sensitivity and 84.9% specificity. Among patients without history of ICS use and smoking, 27.5 ppb was optimal cut-off level for FeNO (AUC = 0.744, 95% CI = 0.579-0.908) to diagnose ACO, with 81.8% sensitivity and 60.7% specificity, and the sensitivity was improved to 91.7% when FeNO was combined with EOS.

Conclusion: The inflammatory biomarkers FeNO and EOS can be used as indicators for differentiating between ACO and COPD alone.

Citing Articles

Differential Clinical Significance of FENO and CANO in Asthma, Chronic Obstructive Pulmonary Disease (COPD), and Asthma-COPD Overlap (ACO).

Zeng G, Xu J, Zeng H, Wang C, Chen L, Yu H J Asthma Allergy. 2024; 17:1151-1161.

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The value of bronchodilator response in FEV1 and FeNO for differentiating between chronic respiratory diseases: an observational study.

Gong Z, Huang J, Xu G, Chen Y, Xu M, Ma Y Eur J Med Res. 2024; 29(1):97.

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A comparison of treatment response to biologics in asthma-COPD overlap and pure asthma: Findings from the PRISM study.

Shim J, Kim H, Kwon J, Park S, Kim S, Kim B World Allergy Organ J. 2023; 16(12):100848.

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Investigating the Effects of a New Peptide, Derived from the Proteinase Inhibitor (EcTI), on Inflammation, Remodeling, and Oxidative Stress in an Experimental Mouse Model of Asthma-Chronic Obstructive Pulmonary Disease Overlap (ACO).

Barbosa J, da Silva L, Joao J, de Campos E, Fukuzaki S, do Nascimento Camargo L Int J Mol Sci. 2023; 24(19).

PMID: 37834157 PMC: 10573003. DOI: 10.3390/ijms241914710.

Frailty in asthma-COPD overlap: a cross-sectional study of association and risk factors in the NHANES database.

Wang X, Wen J, Gu S, Zhang L, Qi X BMJ Open Respir Res. 2023; 10(1).

PMID: 37336621 PMC: 10314668. DOI: 10.1136/bmjresp-2023-001713.

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