Yong Suk Jo1, Sung Ok Kwon2, Jeeyoung Kim3, Woo Jin Kim3. 1. Division of Pulmonary and Critical Care Medicine, Department of Medicine, Kyung Hee University, Seoul, Korea. 2. Biomedical Research Institute, Kangwon National University, Chuncheon, Korea. 3. Department of Internal Medicine and Environmental Health Center, Kangwon National University Hospital, Kangwon National University School of Medicine, Chuncheon, Korea.
Abstract
BACKGROUND: There is no standardized definition of the asthma-chronic obstructive pulmonary disease (COPD) overlap (ACO). Although the blood eosinophil count is regarded as a biomarker for identifying ACO, it has no distinct value. This study aimed to measure plasma levels of neutrophil gelatinase-associated lipocalin (NGAL), a potential biomarker for distinguishing between ACO and non-ACO COPD. METHODS: We used the Korean cohort in the COPD in dusty area (CODA) study which included 137 subjects with COPD confirmed by spirometry. We defined ACO by a positive bronchodilator response (forced expiratory volume in 1 s, FEV1 >12% and >200 mL from baseline) or based on a previous history of asthma. Plasma levels of NGAL were determined by enzyme immunoassay. RESULTS: Among the 137 subjects, 77 were ACO and 60 were non-ACO COPD. Overall, the plasma NGAL levels were 15.9±7.9 and 15.6±6.6 ng/mL for non-ACO and ACO subjects respectively, and not significantly different. However, NGAL levels were significantly higher in female subjects with ACO (17.0±6.4 vs. 11.1±4.5, P=0.01). In female subjects, NGAL levels showed a good predictive ability to discriminate between ACO and non-ACO COPD [area under the receiver operating characteristic curve (AUROC), 0.77]; the predictive ability was similar to that of the blood eosinophil count (AUROC, 0.79). There was a higher probability of discriminating ACO from non-ACO among subjects in the highest tertile of NGAL levels (odds ratio, 1.72; 95% confidence interval, 0.69-4.28; P for trend =0.01). CONCLUSIONS: NGAL levels were significantly higher in ACO compared to non-ACO COPD in female subjects. After adjusting for gender as a confounding factor, the ability to distinguish ACO was better at higher levels of NGAL.
BACKGROUND: There is no standardized definition of the asthma-chronic obstructive pulmonary disease (COPD) overlap (ACO). Although the blood eosinophil count is regarded as a biomarker for identifying ACO, it has no distinct value. This study aimed to measure plasma levels of neutrophil gelatinase-associated lipocalin (NGAL), a potential biomarker for distinguishing between ACO and non-ACO COPD. METHODS: We used the Korean cohort in the COPD in dusty area (CODA) study which included 137 subjects with COPD confirmed by spirometry. We defined ACO by a positive bronchodilator response (forced expiratory volume in 1 s, FEV1 >12% and >200 mL from baseline) or based on a previous history of asthma. Plasma levels of NGAL were determined by enzyme immunoassay. RESULTS: Among the 137 subjects, 77 were ACO and 60 were non-ACO COPD. Overall, the plasma NGAL levels were 15.9±7.9 and 15.6±6.6 ng/mL for non-ACO and ACO subjects respectively, and not significantly different. However, NGAL levels were significantly higher in female subjects with ACO (17.0±6.4 vs. 11.1±4.5, P=0.01). In female subjects, NGAL levels showed a good predictive ability to discriminate between ACO and non-ACO COPD [area under the receiver operating characteristic curve (AUROC), 0.77]; the predictive ability was similar to that of the blood eosinophil count (AUROC, 0.79). There was a higher probability of discriminating ACO from non-ACO among subjects in the highest tertile of NGAL levels (odds ratio, 1.72; 95% confidence interval, 0.69-4.28; P for trend =0.01). CONCLUSIONS: NGAL levels were significantly higher in ACO compared to non-ACO COPD in female subjects. After adjusting for gender as a confounding factor, the ability to distinguish ACO was better at higher levels of NGAL.
Authors: G A Finlay; K J Russell; K J McMahon; E M D'arcy; J B Masterson; M X FitzGerald; C M O'Connor Journal: Thorax Date: 1997-06 Impact factor: 9.139
Authors: Inga-Cecilie Sørheim; Ane Johannessen; Amund Gulsvik; Per S Bakke; Edwin K Silverman; Dawn L DeMeo Journal: Thorax Date: 2010-06 Impact factor: 9.139
Authors: Chin Kook Rhee; Hyoung Kyu Yoon; Kwang Ha Yoo; Young Sam Kim; Sei Won Lee; Yong Bum Park; Jin Hwa Lee; Yuri Kim; Kyungjoo Kim; Jinhee Kim; Yeon Mok Oh; Sang Do Lee Journal: COPD Date: 2013-10-10 Impact factor: 2.409
Authors: T Betsuyaku; M Nishimura; K Takeyabu; M Tanino; P Venge; S Xu; Y Kawakami Journal: Am J Respir Crit Care Med Date: 1999-06 Impact factor: 21.405
Authors: Fernando J Martinez; Jeffrey L Curtis; Frank Sciurba; Jeanette Mumford; Nicholas D Giardino; Gail Weinmann; Ella Kazerooni; Susan Murray; Gerard J Criner; Donald D Sin; James Hogg; Andrew L Ries; MeiLan Han; Alfred P Fishman; Barry Make; Eric A Hoffman; Zab Mohsenifar; Robert Wise Journal: Am J Respir Crit Care Med Date: 2007-04-12 Impact factor: 21.405
Authors: Mark T Dransfield; George R Washko; Marilyn G Foreman; Raul San Jose Estepar; John Reilly; William C Bailey Journal: Chest Date: 2007-06-15 Impact factor: 9.410
Authors: Laura Bäz; Gudrun Dannberg; Katja Grün; Julian Westphal; Sven Möbius-Winkler; Christian Jung; Alexander Pfeil; P Christian Schulze; Marcus Franz Journal: Int J Mol Sci Date: 2020-06-11 Impact factor: 5.923