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Article ; Online: Successful Use of Easyhaler

Kainu, Annette / Vartiainen, Ville A / Mazur, Witold / Hisinger-Mölkänen, Hanna / Lavorini, Federico / Janson, Christer / Andersson, Martin

Pulmonary therapy

2024 Volume 10, Issue 1, Page(s) 133–142

Abstract: Introduction: There is increasing pressure to use environmentally friendly dry powder inhalers (DPI) instead of pressurized metered-dose inhalers (pMDI). However, correct inhalation technique is needed for effective inhaler therapy, and there is ... ...

Abstract	Introduction: There is increasing pressure to use environmentally friendly dry powder inhalers (DPI) instead of pressurized metered-dose inhalers (pMDI). However, correct inhalation technique is needed for effective inhaler therapy, and there is persistent concern whether patients with chronic obstructive pulmonary disease (COPD) can generate sufficient inspiratory effort to use DPIs successfully. The aims of this study were to find clinical predictors for peak inspiratory flow rate (PIF) and to assess whether patients with COPD had difficulties in generating sufficient PIF with a high resistance DPI. Methods: Pooled data of 246 patients with COPD from previous clinical trials was analyzed to find possible predictors of PIF via the DPI Easyhaler (PIFEH) and to assess the proportion of patients able to achieve an inhalation flow rate of 30 l/min, which is needed to use the Easyhaler successfully. Results: The mean PIF was 56.9 l/min and 99% (243/246) of the study patients achieved a PIF ≥ 30 l/min. A low PIF was associated with female gender and lower forced expiratory volume in 1 s (FEV1), but the association was weak and a statistical model including both only accounted for 18% of the variation seen in PIFEH. Conclusions: Based on our results, impaired expiratory lung function or patient characteristics do not predict patients' ability to use DPIs in COPD; 99% of the patients generated sufficient PIFEH for successful dose delivery. Considering the targets for sustainability in health care, this should be addressed as DPIs are a potential option for most patients when choosing the right inhaler for the patient. Trial registration: Two of three included trials were registered under numbers NCT04147572 and NCT01424137. Third trial preceded registration platforms and therefore, was not registered.
Language	English
Publishing date	2024-01-03
Publishing country	United States
Document type	Journal Article
ISSN	2364-1746
ISSN (online)	2364-1746
DOI	10.1007/s41030-023-00246-8
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Article: In bronchiectasis, poor physical capacity correlates with poor quality of life.

Mäntylä, Jarkko / Mazur, Witold / Törölä, Tanja / Bergman, Paula / Kauppi, Paula

European clinical respiratory journal

2022 Volume 9, Issue 1, Page(s) 2095104

Abstract: Purpose: Patients with bronchiectasis (BE) who suffer frequent exacerbations are likely to experience negative effects on quality of life (QoL) and require more healthcare utilization. We aimed to discover, in a cohort of Finnish BE patients, those risk ...

Abstract	Purpose: Patients with bronchiectasis (BE) who suffer frequent exacerbations are likely to experience negative effects on quality of life (QoL) and require more healthcare utilization. We aimed to discover, in a cohort of Finnish BE patients, those risk factors that influence QoL. Methods: Non-cystic fibrosis BE patients of a Helsinki University Hospital cohort were examined with high-resolution computed tomography (HRCT) of the chest. They completed a disease-specific quality of life-bronchiectasis (QoL-B) questionnaire in Finnish translation. We considered scores in the lowest quarter (25%) of that QoL-B scale to indicate poor QoL. The bronchiectasis severity index (BSI), FACED score, and modified Medical Research Council (mMRC) dyspnoea scale were used. Results: Overall, of 95 adult BE patients, mean age was 69 (SD ± 13) and 79% were women. From the cohort, 82% presented with chronic sputum production and exacerbations, at a median rate of 1.7 (SD ± 1.6). The number of exacerbations (OR 1.7), frequent exacerbations (≥3 per year) (OR 4.9), high BSI score (OR 1.3), and extensive disease (≥3 lobes) (OR 3.7) were all predictive of poor QoL. Frequent exacerbations were associated with bronchial bacterial colonisation, low forced expiratory volume in 1 s (FEV1), and radiological disease severity. Based on the BSI, 34.1% of our cohort had severe disease, with 11.6% classified as severe according to their FACED score. The mMRC dyspnoea score ( Conclusion: The strongest determinants of poor QoL in the cohort of Finnish BE patients were frequent exacerbations, radiological disease severity, and high BSI score. Neither comorbidities nor BE aetiology appeared to affect QoL. Reduced physical capacity correlated with dyspnoea and severe disease. Study registration: University of Helsinki, Faculty of Medicine, 148/16.08.2017.
Language	English
Publishing date	2022-06-30
Publishing country	United States
Document type	Journal Article
ZDB-ID	2834928-3
ISSN	2001-8525
ISSN	2001-8525
DOI	10.1080/20018525.2022.2095104
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Article ; Online: Mortality of asthma, COPD, and asthma-COPD overlap during an 18-year follow up.

Mattila, Tiina / Vasankari, Tuula / Kauppi, Paula / Mazur, Witold / Härkänen, Tommi / Heliövaara, Markku

Respiratory medicine

2022 Volume 207, Page(s) 107112

Abstract: Background: We studied asthma, COPD, and asthma-COPD overlap (ACO) to predict mortality in a cohort of Finnish adults with an 18-year follow up.: Methods: A national health examination survey representing Finnish adults aged ≥30 years was performed ... ...

Abstract	Background: We studied asthma, COPD, and asthma-COPD overlap (ACO) to predict mortality in a cohort of Finnish adults with an 18-year follow up. Methods: A national health examination survey representing Finnish adults aged ≥30 years was performed in 2000-2001. The study cohort included 5922 participants (73.8% of the sample) with all relevant data, including a comprehensive clinical examination and spirometry. These participants were followed continuously from baseline until end of 2018 for total, cardiovascular, cancer, and respiratory mortality through a record linkage. Asthma, COPD, and ACO were defined based on the survey data, including spirometry and register data. There were three separate groups of obstructive subjects (one definition excluding the others). Results: Asthma and COPD were significantly associated with higher total mortality in Cox's model adjusted for sex, age, smoking, education level, BMI, leisure time physical activity, cardiovascular disease, diabetes, and hypertension. Hazard ratios (HR) (95% confidence interval [CI]) for asthma, COPD, and ACO were 1.29 (1.05-1.58), 1.50 (1.20-1.88), and 1.26 (0.97-1.65), respectively. Additionally, asthma (HR 1.47, 95% CI 1.09-1.97) and COPD (HR 1.53, 95% CI 1.08-2.16) were associated with cardiovascular mortality. Although ACO did not predict mortality in the whole cohort, there was a significant association with mortality risk among those with hs-CRP 1-2.99 mg/l. Conclusions: Asthma or COPD predicts higher total mortality and premature death from cardiovascular diseases.
MeSH term(s)	Adult ; Humans ; Asthma ; Cardiovascular Diseases ; Diabetes Mellitus ; Follow-Up Studies ; Lung ; Pulmonary Disease, Chronic Obstructive ; Finland
Language	English
Publishing date	2022-12-31
Publishing country	England
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	1003348-8
ISSN	1532-3064 ; 0954-6111
ISSN (online)	1532-3064
ISSN	0954-6111
DOI	10.1016/j.rmed.2022.107112
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Article ; Online: Asthma as aetiology of bronchiectasis in Finland.

Mäntylä, Jarkko / Mazur, Witold / Törölä, Tanja / Bergman, Paula / Saarinen, Tuomas / Kauppi, Paula

Respiratory medicine

2019 Volume 152, Page(s) 105–111

Abstract: Background: By definition bronchiectasis (BE) means destructed structure of normal bronchus as a consequence of frequent bacterial infections and inflammation. In many senses, BE is a neglected orphan disease. A recent pan-European registry study, ... ...

Abstract	Background: By definition bronchiectasis (BE) means destructed structure of normal bronchus as a consequence of frequent bacterial infections and inflammation. In many senses, BE is a neglected orphan disease. A recent pan-European registry study, EMBARC, has been set up in order to better understand its pathophysiology, better phenotype patients, and to individualize their management. Aim: To examine the aetiology and co-morbidity of BE in the capital area in Finland. Methods: Two hundred five patients with BE diagnosis and follow up visits between 2016 and 2017 in Helsinki University Hospital were invited to participate in the study. Baseline demographics, lung functions, imaging, microbiological, and therapeutic data, together with co-morbidities were entered into EMBARC database. Clinical characteristics, aetiologic factors, co-morbidities, and risk factors for extensive BE were explored. Results: To the study included 95 adult patients and seventy nine percent of the BE patients were women. The mean age was 69 years (SD ± 13). Asthma was a comorbid condition in 68% of the patients but in 26% it was estimated to be the cause of BE. Asthma was aetiological factor for BE if it had been diagnosed earlier than BE. As 41% BE were idiopathic, in 11% the disorder was postinfectious and others were associated to rheumatic disease, Alpha-1-antitrypsin deficiency, IgG deficiency and Kartagener syndrome. The most common co-morbidities in addition to asthma were cardiovascular disease (30%), gastroesophageal reflux disease (26%), overweight (22%), diabetes (16%), inactive neoplasia (15%), and immunodeficiency (12%). Extensive BE was found in 68% of BE patients in whom four or more lobes were affected. Risk factors for extensive BE were asthma (OR 2.7), asthma as aetiology for BE (OR 4.3), and rhinosinusitis (OR 3.1). Conclusions: Asthma was associated to BE in 68% and it was estimated as aetiology in every fourth patient. However, retrospectively, it is difficult to exclude asthma as a background cause in patients with asthma-like symptoms and respiratory infections. We propose asthma as an aetiology factor for BE if it is diagnosed earlier than BE. Asthma and rhinosinusitis were predictive for extensive BE.
MeSH term(s)	Aged ; Aged, 80 and over ; Asthma/complications ; Asthma/epidemiology ; Bronchiectasis/diagnosis ; Bronchiectasis/epidemiology ; Bronchiectasis/etiology ; Bronchiectasis/physiopathology ; Comorbidity/trends ; Female ; Finland/epidemiology ; Gastroesophageal Reflux/complications ; Gastroesophageal Reflux/epidemiology ; Humans ; Immunologic Deficiency Syndromes/complications ; Immunologic Deficiency Syndromes/epidemiology ; Incidence ; Kartagener Syndrome/complications ; Kartagener Syndrome/epidemiology ; Male ; Middle Aged ; Predictive Value of Tests ; Pulmonary Disease, Chronic Obstructive/diagnosis ; Pulmonary Disease, Chronic Obstructive/physiopathology ; Respiratory Tract Infections/complications ; Respiratory Tract Infections/epidemiology ; Rhinitis/complications ; Rhinitis/epidemiology ; Risk Factors ; Sinusitis/complications ; Sinusitis/epidemiology ; alpha 1-Antitrypsin Deficiency/complications ; alpha 1-Antitrypsin Deficiency/epidemiology
Language	English
Publishing date	2019-04-30
Publishing country	England
Document type	Comparative Study ; Journal Article ; Multicenter Study ; Research Support, Non-U.S. Gov't
ZDB-ID	1003348-8
ISSN	1532-3064 ; 0954-6111
ISSN (online)	1532-3064
ISSN	0954-6111
DOI	10.1016/j.rmed.2019.04.022
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Article: Keuhkoahtaumataudin kliiniset alatyypit.

Mazur, Witold / Laitinen, Tarja / Kinnula, Vuokko

Duodecim; laaketieteellinen aikakauskirja

2013 Volume 129, Issue 2, Page(s) 127–136

Abstract: COPD--a progressive inflammatory disorder in the airways and lung parenchyma - is also associated with manifestations beyond the lungs. Although the diagnosis of COPD is based on spirometry, severity of airflow obstruction poorly predicts clinically ... ...

Title translation	Chronic obstructive pulmonary disease (COPD) phenotypes.
Abstract	COPD--a progressive inflammatory disorder in the airways and lung parenchyma - is also associated with manifestations beyond the lungs. Although the diagnosis of COPD is based on spirometry, severity of airflow obstruction poorly predicts clinically important outcomes. Recently a COPD phenotype was defined as "a single or combination of disease attributes that describe differences between individuals with COPD as they relate to clinically meaningful outcomes". Four predominant clinical phenotypes were introduced. Awareness of them can lead to more accurate diagnostics and treatments specifically targeted for a specific subpopulation.
MeSH term(s)	Humans ; Phenotype ; Pulmonary Disease, Chronic Obstructive/classification ; Pulmonary Disease, Chronic Obstructive/diagnosis ; Spirometry
Language	Finnish
Publishing date	2013
Publishing country	Finland
Document type	English Abstract ; Journal Article ; Review
ZDB-ID	127604-9
ISSN	0012-7183
ISSN	0012-7183
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Article ; Online: Reduced endogenous secretory RAGE in blood and bronchoalveolar lavage fluid is associated with poor prognosis in idiopathic pulmonary fibrosis.

Yamaguchi, Kakuhiro / Iwamoto, Hiroshi / Mazur, Witold / Miura, Shinichiro / Sakamoto, Shinjiro / Horimasu, Yasushi / Masuda, Takeshi / Miyamoto, Shintaro / Nakashima, Taku / Ohshimo, Shinichiro / Fujitaka, Kazunori / Hamada, Hironobu / Hattori, Noboru

Respiratory research

2020 Volume 21, Issue 1, Page(s) 145

Abstract: Background: The endogenous secretory receptor for advanced glycation end products (esRAGE) is a soluble isoform produced by alternative splicing of the RAGE gene. The isoform has anti-inflammatory properties due to its inhibition of the RAGE/ligand ... ...

Abstract	Background: The endogenous secretory receptor for advanced glycation end products (esRAGE) is a soluble isoform produced by alternative splicing of the RAGE gene. The isoform has anti-inflammatory properties due to its inhibition of the RAGE/ligand interaction and is reduced in the lung tissue of patients with idiopathic pulmonary fibrosis (IPF). This study aimed to investigate the association of esRAGE serum and bronchoalveolar lavage fluid (BALF) levels with progression of IPF. Methods: This study included 79 IPF patients and 90 healthy controls. IPF and control serum esRAGE levels were compared, and the correlation between serum and BALF esRAGE levels was analyzed in 57 IPF patient samples. We also investigated the relationship of esRAGE serum and BALF levels with prognoses and lung function parameters in patients with IPF. Results: Serum esRAGE levels in IPF patients were significantly lower than those in healthy controls (162.0 ± 102.4 ng/ml and 200.7 ± 107.3 ng/ml, p = 0.009), although the baseline characteristics of age and smoking history were not matched. Serum levels of esRAGE were correlated with BALF esRAGE levels (r Conclusions: Decreased esRAGE levels in BALF and blood were associated with poor prognoses in patients with IPF. These results suggest that esRAGE could be related to the pathophysiology of IPF and serum esRAGE could be a potential prognostic marker of IPF.
MeSH term(s)	Aged ; Biomarkers/metabolism ; Bronchoalveolar Lavage Fluid/chemistry ; Female ; Humans ; Idiopathic Pulmonary Fibrosis/diagnosis ; Idiopathic Pulmonary Fibrosis/metabolism ; Male ; Middle Aged ; Prognosis ; Receptor for Advanced Glycation End Products/metabolism
Chemical Substances	Biomarkers ; Receptor for Advanced Glycation End Products ; esRAGE protein, human
Language	English
Publishing date	2020-06-11
Publishing country	England
Document type	Journal Article
ZDB-ID	2041675-1
ISSN	1465-993X ; 1465-9921
ISSN (online)	1465-993X
ISSN	1465-9921
DOI	10.1186/s12931-020-01410-3
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Article ; Online: Sputum Vitamin D Binding Protein (VDBP) GC1S/1S Genotype Predicts Airway Obstruction: A Prospective Study in Smokers with COPD.

Gao, Jing / Törölä, Tanja / Li, Chuan-Xing / Ohlmeier, Steffen / Toljamo, Tuula / Nieminen, Pentti / Hattori, Noboru / Pulkkinen, Ville / Iwamoto, Hiroshi / Mazur, Witold

International journal of chronic obstructive pulmonary disease

2020 Volume 15, Page(s) 1049–1059

Abstract: Introduction: The vitamin D binding protein (VDBP, also known as GC-globulin) and vitamin D deficiency have been associated with chronic obstructive pulmonary disease (COPD). rs7041 and rs4588 are two single nucleotide polymorphisms of the VDBP gene, ... ...

Abstract	Introduction: The vitamin D binding protein (VDBP, also known as GC-globulin) and vitamin D deficiency have been associated with chronic obstructive pulmonary disease (COPD). rs7041 and rs4588 are two single nucleotide polymorphisms of the VDBP gene, including three common allelic variants (GC1S, GC1F and GC2). Previous studies primarily assessed the serum levels of vitamin D and VDBP in COPD. However, less is known regarding the impact of the local release of VDBP on COPD lung function. Thus, we examined the association of sputum and plasma VDBP with lung function at baseline and at four years, and examined potential genetic polymorphism interactions. Methods: The baseline levels of sputum VDBP, plasma VDBP and plasma 25-OH vitamin D, as well as the GC rs4588 and rs7041 genotypes, were assessed in a 4-year Finnish follow-up cohort (n = 233) of non-smokers, and smokers with and without COPD. The associations between the VDBP levels and the longitudinal decline of lung function were further analysed. Results: High frequencies of the haplotypes in rs7041/rs4588 were homozygous GC1S/1S (42.5%). Higher sputum VDBP levels in stage I and stage II COPD were observed only in carriers with GC1S/1S genotype when compared with non-smokers (p = 0.034 and p = 0.002, respectively). Genotype multivariate regression analysis indicated that the baseline sputum VDBP and FEV1/FVC ratio at baseline independently predicted FEV1% at follow-up. Discussion and conclusion: The baseline sputum VDBP expression was elevated in smokers with COPD among individuals with the GC1S/1S genotype, and predicted follow-up airway obstruction. Our results suggest that the GC polymorphism should be considered when exploring the potential of VDBP as a biomarker for COPD.
MeSH term(s)	Airway Obstruction ; Genetic Predisposition to Disease ; Genotype ; Humans ; Polymorphism, Single Nucleotide ; Prospective Studies ; Pulmonary Disease, Chronic Obstructive/diagnosis ; Pulmonary Disease, Chronic Obstructive/genetics ; Smokers ; Sputum ; Vitamin D ; Vitamin D-Binding Protein/genetics
Chemical Substances	Vitamin D-Binding Protein ; Vitamin D (1406-16-2)
Language	English
Publishing date	2020-05-15
Publishing country	New Zealand
Document type	Journal Article
ZDB-ID	2212419-6
ISSN	1178-2005 ; 1176-9106
ISSN (online)	1178-2005
ISSN	1176-9106
DOI	10.2147/COPD.S234464
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Article ; Online: DNA methylation profiling in peripheral lung tissues of smokers and patients with COPD.

Sundar, Isaac K / Yin, Qiangzong / Baier, Brian S / Yan, Li / Mazur, Witold / Li, Dongmei / Susiarjo, Martha / Rahman, Irfan

Clinical epigenetics

2017 Volume 9, Page(s) 38

Abstract: Background: Epigenetics changes have been shown to be affected by cigarette smoking. Cigarette smoke (CS)-mediated DNA methylation can potentially affect several cellular and pathophysiological processes, acute exacerbations, and comorbidity in the ... ...

Abstract	Background: Epigenetics changes have been shown to be affected by cigarette smoking. Cigarette smoke (CS)-mediated DNA methylation can potentially affect several cellular and pathophysiological processes, acute exacerbations, and comorbidity in the lungs of patients with chronic obstructive pulmonary disease (COPD). We sought to determine whether genome-wide lung DNA methylation profiles of smokers and patients with COPD were significantly different from non-smokers. We isolated DNA from parenchymal lung tissues of patients including eight lifelong non-smokers, eight current smokers, and eight patients with COPD and analyzed the samples using Illumina's Infinium HumanMethylation450 BeadChip. Results: Our data revealed that the differentially methylated genes were related to top canonical pathways (e.g., G beta gamma signaling, mechanisms of cancer, and nNOS signaling in neurons), disease and disorders (organismal injury and abnormalities, cancer, and respiratory disease), and molecular and cellular functions (cell death and survival, cellular assembly and organization, cellular function and maintenance) in patients with COPD. The genome-wide DNA methylation analysis identified suggestive genes, such as Conclusions: Our study suggests that DNA methylation in suggestive genes, such as
MeSH term(s)	Adaptor Proteins, Signal Transducing/genetics ; Aged ; BH3 Interacting Domain Death Agonist Protein/genetics ; DNA Fingerprinting ; DNA Methylation ; Female ; Humans ; Lung/metabolism ; Male ; Middle Aged ; Pulmonary Disease, Chronic Obstructive/genetics ; Receptors, GABA-A/genetics ; Sequence Analysis, DNA ; Smoking/genetics
Chemical Substances	Adaptor Proteins, Signal Transducing ; BH3 Interacting Domain Death Agonist Protein ; BID protein, human ; GABRB1 protein, human ; NOS1AP protein, human ; Receptors, GABA-A
Language	English
Publishing date	2017-04-14
Publishing country	Germany
Document type	Journal Article ; Research Support, N.I.H., Extramural ; Research Support, Non-U.S. Gov't
ZDB-ID	2553921-8
ISSN	1868-7083 ; 1868-7075
ISSN (online)	1868-7083
ISSN	1868-7075
DOI	10.1186/s13148-017-0335-5
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Article ; Online: AGER gene polymorphisms and soluble receptor for advanced glycation end product in patients with idiopathic pulmonary fibrosis.

Yamaguchi, Kakuhiro / Iwamoto, Hiroshi / Horimasu, Yasushi / Ohshimo, Shinichiro / Fujitaka, Kazunori / Hamada, Hironobu / Mazur, Witold / Kohno, Nobuoki / Hattori, Noboru

Respirology (Carlton, Vic.)

2017 Volume 22, Issue 5, Page(s) 965–971

Abstract: Background and objective: The receptor for advanced glycation end product (RAGE) is a multiligand cell-surface receptor abundantly expressed in the lung. RAGE/ligand interaction has been postulated to participate in the pathogenesis of inflammatory ... ...

Abstract	Background and objective: The receptor for advanced glycation end product (RAGE) is a multiligand cell-surface receptor abundantly expressed in the lung. RAGE/ligand interaction has been postulated to participate in the pathogenesis of inflammatory diseases, while soluble RAGE (sRAGE) might act as a decoy receptor. A functional polymorphism rs2070600 in the gene coding RAGE (AGER) might modulate its receptor function. The aim of this study was to investigate the association of AGER polymorphisms and circulatory sRAGE with the development and progression of idiopathic pulmonary fibrosis (IPF). Methods: This study comprised 87 Japanese patients with IPF and 303 healthy controls. Seven tag polymorphisms in AGER were genotyped and their distributions were compared. We also measured serum sRAGE levels, and evaluated the correlations of sRAGE levels with AGER polymorphisms and the prognosis of the patients with IPF. Results: The frequency of AGER rs2070600 genotype with minor allele was significantly higher in patients with IPF (OR = 1.84, 95% CI = 1.08-3.10). Additionally, the carriage of the rs2070600 minor allele and the presence of IPF were independently associated with reduced serum levels of sRAGE. Moreover, reduced sRAGE (≤471.8 pg/mL) was related to acute exacerbation of IPF and was an independent predictor of 5-year survival in patients with the disease (hazard ratio (HR) = 7.956, 95% CI = 1.575-53.34). Conclusion: These results suggest a possible association between a functional polymorphism in AGER and IPF disease susceptibility, and indicate a potential prognostic value of circulatory sRAGE.
Language	English
Publishing date	2017-07
Publishing country	Australia
Document type	Journal Article
ZDB-ID	1435849-9
ISSN	1440-1843 ; 1323-7799
ISSN (online)	1440-1843
ISSN	1323-7799
DOI	10.1111/resp.12995
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Article ; Online: Differences in plasma and sputum biomarkers between COPD and COPD-asthma overlap.

Iwamoto, Hiroshi / Gao, Jing / Koskela, Jukka / Kinnula, Vuokko / Kobayashi, Hideo / Laitinen, Tarja / Mazur, Witold

The European respiratory journal

2014 Volume 43, Issue 2, Page(s) 421–429

Abstract: The pathophysiological features of chronic obstructive pulmonary disease (COPD)-asthma overlap are poorly understood and there has been no study of plasma or sputum biomarkers in overlap patients. In order to clarify the similarity and differences ... ...

Abstract	The pathophysiological features of chronic obstructive pulmonary disease (COPD)-asthma overlap are poorly understood and there has been no study of plasma or sputum biomarkers in overlap patients. In order to clarify the similarity and differences between overlap and COPD or asthma, we have investigated four potential biomarkers of COPD: surfactant protein A (SP-A), soluble receptor for advanced glycation end-products (sRAGE), myeloperoxidase (MPO) and neutrophil gelatinase-associated lipocalin (NGAL). SP-A and sRAGE are pneumocyte-derived markers. MPO and NGAL are neutrophil-derived molecules, but NGAL can also be expressed by respiratory epithelial cells. Plasma levels of SP-A and sRAGE and induced sputum levels of MPO and NGAL were measured by enzyme immunoassay/ELISA in 134 subjects: nonsmokers (n=26), smokers (n=23), asthma (n=32), COPD (n=39) and COPD-asthma overlap patients (n=14). In patients with COPD-asthma overlap, sputum MPO and plasma SP-A were significantly elevated whereas plasma sRAGE levels were reduced compared with asthma patients. Only sputum NGAL was significantly elevated in COPD-asthma overlap compared with COPD (p=0.00016) and could be used to differentiate patients with overlap from those with COPD. Increased induced sputum levels of NGAL might be a characteristic feature of overlap, suggesting enhanced neutrophilic airway inflammation and/or airway epithelial injury in COPD-asthma overlap.
MeSH term(s)	Acute-Phase Proteins ; Adult ; Aged ; Asthma/blood ; Asthma/complications ; Biomarkers/blood ; Biomarkers/metabolism ; Cell Differentiation ; Comorbidity ; Enzyme-Linked Immunosorbent Assay ; Female ; Gene Expression Regulation ; Humans ; Inflammation ; Lipocalin-2 ; Lipocalins/blood ; Male ; Middle Aged ; Neutrophils/metabolism ; Peroxidase/blood ; Proto-Oncogene Proteins/blood ; Pulmonary Disease, Chronic Obstructive/blood ; Pulmonary Disease, Chronic Obstructive/complications ; Pulmonary Surfactant-Associated Protein A/metabolism ; Receptor for Advanced Glycation End Products ; Receptors, Immunologic/metabolism ; Smoking ; Sputum/metabolism
Chemical Substances	Acute-Phase Proteins ; Biomarkers ; LCN2 protein, human ; Lipocalin-2 ; Lipocalins ; Proto-Oncogene Proteins ; Pulmonary Surfactant-Associated Protein A ; Receptor for Advanced Glycation End Products ; Receptors, Immunologic ; SFTPA1 protein, human ; Peroxidase (EC 1.11.1.7)
Language	English
Publishing date	2014-02
Publishing country	England
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	639359-7
ISSN	1399-3003 ; 0903-1936
ISSN (online)	1399-3003
ISSN	0903-1936
DOI	10.1183/09031936.00024313
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