title: Gamma globulin fraction of the proteinogram and chronic obstructive pulmonary disease exacerbations.
abstract: OBJECTIVE
  To evaluate the levels of the serum gamma globulin fraction in proteinograms as a biomarker to assess the severity, and to predict the mortality and new exacerbations in patients admitted for an exacerbation of a COPD.
  
  
  METHODS
  The VIRAE study was carried out on a cohort of patients hospitalized for an exacerbation of probable infectious origin of COPD over a period of 2 years. The levels of the serum gamma globulin fraction were analyzed in the proteinogram of 120 patients. The main clinical indicators of severity were also evaluated. Key features were compared in 2 groups (gamma fraction in the proteinogram greater or less than 6.6g/dl).
  
  
  RESULTS
  The levels of the serum gamma fraction in the proteinogram correlated with the FEV1(P=.009), the CRP (P=.04), and the number of readmissions after 6 months of hospitalization (P=.04). We observed a good association with the GOLD scale, the BODE index and the mMRC dyspnea scale; and also with treatment with oral corticoids and home oxygen therapy. We did not find it to be a good predictor of mortality, despite observing increased mortality rates one year after hospital admission in patients with low levels of the factor.
  
  
  CONCLUSIONS
  The levels of the gamma globulin fraction in proteinograms has a good correlation with the FEV1. In addition, they are associated with a greater severity of patients with COPD. This simple biomarker may be useful in identifying high-risk patients.
authors.affiliation: Servicio de Medicina Interna, Hospital de Mataró-Consorci Sanitari del Maresme, Mataró, Barcelona, España; Departamento de Medicina. Universidad de Barcelona, Barcelona, España. Electronic address: rboixeda@csdm.cat.
authors.forename: Ramon
authors.initials: R
authors.lastname: Boixeda
authors.affiliation: Servicio de Medicina Interna, Hospital de Mataró-Consorci Sanitari del Maresme, Mataró, Barcelona, España; Departamento de Medicina, Universidad Autónoma de Barcelona, Barcelona, España.
authors.forename: Josep Antón
authors.initials: JA
authors.lastname: Capdevila
authors.affiliation: Servicio de Medicina Interna, Hospital de Mataró-Consorci Sanitari del Maresme, Mataró, Barcelona, España.
authors.forename: Vanessa
authors.initials: V
authors.lastname: Vicente
authors.affiliation: Unidad de Investigación, Consorci Sanitari del Maresme, Mataró, Barcelona, España.
authors.forename: Elisabet
authors.initials: E
authors.lastname: Palomera
authors.affiliation: Unidad de Neumología, Hospital de Mataró-Consorci Sanitari del Maresme, Mataró, Barcelona, España.
authors.forename: Jordi
authors.initials: J
authors.lastname: Juanola
authors.affiliation: Servicio de Medicina Interna, Hospital de Mataró-Consorci Sanitari del Maresme, Mataró, Barcelona, España.
authors.forename: Laia
authors.initials: L
authors.lastname: Albiach
authors.affiliation: Servicio de Medicina Interna, Hospital de Mataró-Consorci Sanitari del Maresme, Mataró, Barcelona, España.
authors.forename: Ainhoa
authors.initials: A
authors.lastname: Rex
authors.affiliation: Departamento de Medicina, Universidad Autónoma de Barcelona, Barcelona, España; Unidad de Cuidados Intensivos, Hospital de Mataró-Consorci Sanitari del Maresme, Mataró, Barcelona, España.
authors.forename: Jordi
authors.initials: J
authors.lastname: Almirall
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015415:Biomarkers / Q000097:blood; D018450:Disease Progression; D005260:Female; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D011446:Prospective Studies; D029424:Pulmonary Disease, Chronic Obstructive / Q000175:diagnosis* / Q000401:mortality / Q000628:therapy; D012720:Severity of Illness Index; D016019:Survival Analysis; D005719:gamma-Globulins / Q000378:metabolism*
chemical_list: D015415:Biomarkers; D005719:gamma-Globulins
keywords: Acute exacerbation; Biomarcador; Biomarker; Chronic obstructive pulmonary disease; Enfermedad pulmonar obstructiva crónica; Etiología infecciosa; Exacerbación aguda; Gamma globulins; Gammaglobulinas; Infectious etiology; Mortalidad; Mortality; Prognostic; Pronóstico