title: Low erythropoietin plasma levels during exacerbations of COPD.
abstract: BACKGROUND
  It is known that pro-inflammatory cytokines suppress in vitro the gene expression and protein production of erythropoietin (Epo). We hypothesized that systemic inflammation in patients with chronic obstructive pulmonary disease (COPD) may influence Epo production, particularly during episodes of exacerbation of the disease (ECOPD) where an inflammatory burst is known to occur.
  
  
  OBJECTIVE
  We compared the plasma levels of Epo and high-sensitivity (hs) C-reactive protein (hsC-RP) in patients hospitalized because of ECOPD (n = 26; FEV(1): 48 +/- 15% predicted), patients with clinically stable COPD (n = 31; FEV(1): 49 +/- 17% predicted), smokers with normal lung function (n = 9), and healthy never smokers (n = 9).
  
  
  METHODS
  Venous blood samples were taken between 9 and 10 a.m. after an overnight fast into tubes with EDTA (10 ml) or without EDTA (10 ml). Plasma levels of Epo (R&D Systems Inc., Minneapolis, Minn., USA) and hsC-RP (BioSource, Belgium) were determined by ELISA.
  
  
  RESULTS
  Log-Epo plasma levels were significantly lower (0.46 +/- 0.32 mU/ml) in ECOPD than in stable COPD (1.05 +/- 0.23 mU/ml), smokers (0.95 +/- 0.11 mU/ml) and never smokers with normal lung function (0.92 +/- 0.19 mU/ml) (p < 0.01, each). In a subset of 8 COPD patients who could be studied both during ECOPD and clinical stability, log-Epo increased from 0.49 +/- 0.42 mU/ml during ECOPD to 0.97 +/- 0.19 mU/ml during stability (p < 0.01). In patients with COPD log-Epo was significantly related to hsC-RP (r = -0.55, p < 0.0001) and circulating neutrophils (r = -0.48, p < 0.0001).
  
  
  CONCLUSIONS
  These results show that the plasma levels of Epo are reduced during ECOPD likely in relation to a burst of systemic inflammation.
authors: Servei de Pneumologia, Hospital Universitari Son Dureta, C/Andrea Doria 55, Palma de Mallorca, Spain. ernest.sala@ssib.es
authors: Ernest
authors: E
authors: Sala
authors: Catalina
authors: C
authors: Balaguer
authors: Cristina
authors: C
authors: Villena
authors: Angel
authors: A
authors: Ríos
authors: Aina
authors: A
authors: Noguera
authors: Belén
authors: B
authors: Núñez
authors: Alvar
authors: A
authors: Agustí
mesh_terms: D000368:Aged; D002097:C-Reactive Protein / Q000378:metabolism*; D004921:Erythropoietin / Q000097:blood*; D006801:Humans; D007249:Inflammation / Q000097:blood*; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D029424:Pulmonary Disease, Chronic Obstructive / Q000097:blood*; D012907:Smoking / Q000097:blood*
chemical_list: D004921:Erythropoietin; D002097:C-Reactive Protein