title: Analysis of sputum markers in the evaluation of lung inflammation and functional impairment in symptomatic smokers and COPD patients.
abstract: The pivotal role of neutrophils and macrophages in smoking-related lung inflammation and COPD development is well-established. We aimed to assess whether sputum concentrations of Human Neutrophil Peptides (HNP), Neutrophil Elastase (NE), Interleukin-8 (IL-8), and Metalloproteinase-9 (MMP-9), major products of neutrophils and macrophages, could be used to trace airway inflammation and progression towards pulmonary functional impairment characteristic of COPD. Forty-two symptomatic smokers and 42 COPD patients underwent pulmonary function tests; sputum samples were collected at enrolment, and 6 months after smoking cessation. HNP, NE, IL-8, MMP-9 levels were increased in individuals with COPD (p < 0.0001). HNP and NE concentrations were higher in patients with severe airways obstruction, as compared to patients with mild-to-moderate COPD (p =0.002). A negative correlation was observed between FEV<formula>_{1}</formula> and HNP, NE and IL-8 levels (p < 0.01), between FEV<formula>_{1}</formula>/FVC and HNP, NE and IL-8 levels (p< 0.01), and between NE enrolment levels and FEV<formula>_{1}</formula> decline after 2 years (p =0.04). ROC analysis, to discriminate symptomatic smokers and COPD patients, showed the following AUCs: for HNP 0.92; for NE 0.81; for IL-8 0.89; for MMP-9 0.81; for HNP, IL-8 and MMP-9 considered together 0.981. The data suggest that the measurement of sputum markers may have an important role in clinical practice for monitoring COPD.
authors: Department of Cardiovascular and Respiratory Sciences, 'Sapienza' University of Rome, S.Camillo-Forlanini Hospital, Italy. rpaone1023@yahoo.com
authors: Gregorino
authors: G
authors: Paone
authors: Vittoria
authors: V
authors: Conti
authors: Annarita
authors: A
authors: Vestri
authors: Alvaro
authors: A
authors: Leone
authors: Giovanni
authors: G
authors: Puglisi
authors: Fulvio
authors: F
authors: Benassi
authors: Giuseppe
authors: G
authors: Brunetti
authors: Giovanni
authors: G
authors: Schmid
authors: Ilio
authors: I
authors: Cammarella
authors: Claudio
authors: C
authors: Terzano
mesh_terms: D000328:Adult; D015415:Biomarkers / Q000032:analysis; D005260:Female; D006801:Humans; D016209:Interleukin-8 / Q000032:analysis; D019272:Leukocyte Elastase / Q000032:analysis; D008297:Male; D020780:Matrix Metalloproteinase 9 / Q000032:analysis; D008875:Middle Aged; D011014:Pneumonia / Q000503:physiopathology*; D029424:Pulmonary Disease, Chronic Obstructive / Q000503:physiopathology*; D012907:Smoking / Q000503:physiopathology*; D016540:Smoking Cessation; D013183:Sputum / Q000737:chemistry*; D023084:alpha-Defensins / Q000032:analysis
chemical_list: D015415:Biomarkers; D016209:Interleukin-8; D023084:alpha-Defensins; D019272:Leukocyte Elastase; D020780:Matrix Metalloproteinase 9