title: Differences in local and systemic inflammatory markers in  patients with obstructive airways disease.
abstract: BACKGROUND
  Asthma and chronic obstructive pulmonary disease (COPD) are characterised by airway and systemic inflammation, but little is known about differences and similarities in inflammatory markers in patients with obstructive airways disease.
  
  
  METHODS
  In 210 adult patients presenting to their general practitioners with symptoms suggestive of obstructive airways disease, lung function, fractional exhaled nitric oxide (FE(NO)), blood eosinophils, and serum levels of high-sensitivity C-reactive protein (hs-CRP) and IgE were measured.
  
  
  RESULTS
  hs-CRP levels were increased in COPD patients (p=0.009), whereas FE(NO), IgE, and eosinophils were increased in patients with asthma (p=0.009, p=0.041, and p=0.009, respectively). In the ROC analysis, hs-CRP had the largest area under the curve (AUC=0.651; 95% confidence interval (CI) 0.552 to 0.749), with a specifity of 83% and a sensitivity of 42% for the diagnosis of COPD. FE(NO) was the most accurate marker in the diagnosis of asthma (AUC=0.618; 95% CI 0.529 to 0.706). Serum hs-CRP levels correlated with the number of smoking pack-years (r=0.218, p=0.001) and inversely with lung function parameters.
  
  
  CONCLUSIONS
  Levels of serum hs-CRP, IgE, blood eosinophils, and FE(NO) identify distinct aspects of local and systemic inflammation in patients with obstructive airways disease. This might help to differentiate between asthma and COPD in primary care patients when spirometry is not available.
authors.affiliation: Technische Universität München, Klinikum rechts der Isar, Institute of General Practice, Munich, Germany. talysat@gmx.de
authors.forename: Lisa
authors.initials: L
authors.lastname: Tilemann
authors.forename: Lena
authors.initials: L
authors.lastname: Gindner
authors.forename: Franz
authors.initials: F
authors.lastname: Meyer
authors.forename: Joachim
authors.initials: J
authors.lastname: Szecsenyi
authors.forename: Antonius
authors.initials: A
authors.lastname: Schneider
mesh_terms: D000046:Academic Medical Centers; D000328:Adult; D000368:Aged; D015415:Biomarkers / Q000097:blood*; D002097:C-Reactive Protein / Q000032:analysis; D004804:Eosinophils; D005260:Female; D005858:Germany / Q000453:epidemiology; D006801:Humans; D007073:Immunoglobulin E / Q000097:blood; D008173:Lung Diseases, Obstructive / Q000097:blood* / Q000175:diagnosis*; D008297:Male; D008875:Middle Aged; D009569:Nitric Oxide / Q000032:analysis; D012372:ROC Curve; D012129:Respiratory Function Tests; D012907:Smoking / Q000453:epidemiology
chemical_list: D015415:Biomarkers; D009569:Nitric Oxide; D007073:Immunoglobulin E; D002097:C-Reactive Protein