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Popețiu RO, Donath-Miklos I, Borta SM, Rus LA, Vîlcea A, Nica DV, Pușchiță M. Serum YKL-40 Levels, Leukocyte Profiles, and Acute Exacerbations of Advanced COPD. J Clin Med 2023; 12:6106. [PMID: 37763047 PMCID: PMC10532402 DOI: 10.3390/jcm12186106] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2023] [Revised: 09/14/2023] [Accepted: 09/19/2023] [Indexed: 09/29/2023] Open
Abstract
Little information exists on YKL-40-a key protein in tissue remodeling-and complete blood count (CBC) parameters during acute exacerbations of advanced chronic obstructive pulmonary disease (COPD). This pilot exploratory study (August 2020-January 2021) investigated the connection between serum YKL-40 levels and CBC profile in sex- and age-matched individuals with severe COPD (GOLD stage III, n = 23, median age = 66 years, 65.21% males) and very severe COPD (GOLD stage IV, n = 24, median age = 66.5 years, 74.81% males). The measured parameters were serum YKL-40, absolute leukocyte count (ALLC), absolute neutrophil count (ANC), neutrophil percentage, absolute lymphocyte count (ALC), lymphocyte percentage, neutrophil-to-lymphocyte ratio (NLR), absolute eosinophil count (AEC), eosinophil percentage, absolute monocyte count (AMC), monocyte percentage, absolute basophil count (ABC), basophil percentage, hemoglobin levels, and hematocrit concentrations. No significant inter-group differences were observed. However, high YKL-40 subjects (n = 23)-as stratified via median YKL-40 (3934.5 pg/mL)-showed significantly increased neutrophil percentage and NLR but significantly lower lymphocyte-, eosinophil-, and basophil-related parameters compared to low YKL-40 patients (n = 24). These results reveal multidimensional, YKL-40-associated changes in leukocyte profile of patients with advanced COPD during acute exacerbations, with potential implications for personalized treatment.
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Affiliation(s)
- Romana Olivia Popețiu
- Department of Internal Medicine, Faculty of Medicine, “Vasile Goldiș” Western University of Arad, Bulevardul Revoluției 94, 310025 Arad, Romania; (S.M.B.); (L.A.R.); (A.V.); (M.P.)
- Arad County Emergency Clinical Hospital, Str. Andrényi Károly Nr. 2-4, 310037 Arad, Romania
| | - Imola Donath-Miklos
- Department of Physiology, Faculty of Medicine, “Vasile Goldiș” Western University of Arad, Bulevardul Revoluției 94, 310025 Arad, Romania;
| | - Simona Maria Borta
- Department of Internal Medicine, Faculty of Medicine, “Vasile Goldiș” Western University of Arad, Bulevardul Revoluției 94, 310025 Arad, Romania; (S.M.B.); (L.A.R.); (A.V.); (M.P.)
- Arad County Emergency Clinical Hospital, Str. Andrényi Károly Nr. 2-4, 310037 Arad, Romania
| | - Larisa Alexandra Rus
- Department of Internal Medicine, Faculty of Medicine, “Vasile Goldiș” Western University of Arad, Bulevardul Revoluției 94, 310025 Arad, Romania; (S.M.B.); (L.A.R.); (A.V.); (M.P.)
- Arad County Emergency Clinical Hospital, Str. Andrényi Károly Nr. 2-4, 310037 Arad, Romania
| | - Anamaria Vîlcea
- Department of Internal Medicine, Faculty of Medicine, “Vasile Goldiș” Western University of Arad, Bulevardul Revoluției 94, 310025 Arad, Romania; (S.M.B.); (L.A.R.); (A.V.); (M.P.)
- Arad County Emergency Clinical Hospital, Str. Andrényi Károly Nr. 2-4, 310037 Arad, Romania
| | - Dragoș Vasile Nica
- The National Institute of Research-Development for Machines and Installations Designed for Agriculture and Food Industry, Bulevardul Ion Ionescu de la Brad 6, 077190 București, Romania;
- Research Center for Pharmaco-Toxicological Evaluations, Faculty of Pharmacy, “Victor Babes” University of Medicine and Pharmacy, Eftimie Murgu Square No. 2, 300041 Timişoara, Romania
| | - Maria Pușchiță
- Department of Internal Medicine, Faculty of Medicine, “Vasile Goldiș” Western University of Arad, Bulevardul Revoluției 94, 310025 Arad, Romania; (S.M.B.); (L.A.R.); (A.V.); (M.P.)
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Diagnostic Value of Serum Chitinase-3-Like Protein 1 for Liver Fibrosis: A Meta-analysis. BIOMED RESEARCH INTERNATIONAL 2022; 2022:3227957. [PMID: 35360517 PMCID: PMC8961437 DOI: 10.1155/2022/3227957] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/31/2021] [Revised: 12/08/2021] [Accepted: 01/03/2022] [Indexed: 02/07/2023]
Abstract
Background Serum chitinase-3-like protein 1 (CHI3L1) is a promising marker for diagnosing liver fibrosis. This meta-analysis was carried out to assess the diagnostic performance of serum CHI3L1 for the estimation of liver fibrosis. Methods Systematic searches were performed on PubMed, Embase, Web of Science, Scopus, the Cochrane Library, Google Scholar, Sinomed, the China National Knowledge Infrastructure (CNKI), the Chinese Medical Journal Database, and the Wanfang databases for available studies. The primary studies were screened strictly according to inclusion and exclusion criteria, and sensitivity, specificity, and other measures of accuracy of serum CHI3L1 for evaluating liver fibrosis were pooled with 95% confidence intervals. I2 was calculated to assess heterogeneity, and sources of heterogeneity were explored by subgroup analysis. Deeks' test was used to assess for publication bias, and likelihood ratio was used to determine posttest probability. Results Our research integrated 11 articles, accounting for 1897 patients older than 18 years old. The pooled sensitivity and specificity for significant fibrosis, advanced fibrosis, and cirrhosis were 0.79 and 0.82 with an area under the receiver operating characteristic curve (AUC) of 0.85, 0.81 and 0.83 with an AUC of 0.91, and 0.72 and 0.74 with an AUC of 0.85, respectively. Random-effects models were used to assess for significant heterogeneity, and subgroup analysis showed that age and aetiology of included patients were likely sources of heterogeneity. No potential publication bias was found for serum CHI3L1 in the diagnosis of significant fibrosis, advanced fibrosis, or cirrhosis, and posttest probability was moderate. Conclusion Measurement of serum CHI3L1 is a feasible diagnostic tool for liver fibrosis.
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Lee JW, Kim MN, Kim EG, Leem JS, Baek SM, Kim MJ, Kim KW, Sohn MH. Chitinase 3-like 1 is involved in the induction of IL-8 expression by double-stranded RNA in airway epithelial cells. Biochem Biophys Res Commun 2022; 592:106-112. [PMID: 35033868 DOI: 10.1016/j.bbrc.2022.01.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2021] [Revised: 01/03/2022] [Accepted: 01/04/2022] [Indexed: 11/25/2022]
Abstract
Viral respiratory infection causes inflammatory lung disease. Chitinase 3-like 1 (CHI3L1) contributes to airway inflammation, but its role in human airway epithelial cells following viral infection is unclear. Thus, we investigated whether CHI3L1 regulates inflammatory responses caused by viral infections in airway epithelial cells. Human bronchial epithelial cells, BEAS-2B, were stimulated with a synthetic analog of viral double-stranded RNA, polyinosinic:polycytidylic acid (poly(I:C)). To confirm the specific role of CHI3L1, CHI3L1 was knocked down in BEAS-2B cells using shRNA lentivirus. The expression of CHI3L1 and proinflammatory cytokines such as IL-8 and phosphorylation of mitogen-activated protein kinase (MAPK) pathways were analyzed. In addition to poly(I:C), BEAS-2B cells were infected with the human respiratory syncytial virus (RSV) A2 strain, and CHI3L1 and IL-8 expression was analyzed. Stimulating the cells with poly(I:C) increased CHI3L1 and IL-8 expression, whereas IL-8 expression was abrogated in CHI3L1 knockdown BEAS-2B cells. Poly(I:C) stimulation of BEAS-2B cells resulted in phosphorylation of MAPK pathways, and inhibition of MAPK pathways significantly abolished IL-8 secretion. Phosphorylation of MAPK pathways was diminished in CHI3L1 knockdown BEAS-2B cells. Infection with RSV increased CHI3L1 and IL-8 expression. IL-8 expression induced by RSV infection was abrogated in CHI3L1 knockdown cells. In conclusion, CHI3L1 may be involved in IL-8 secretion by regulating MAPK pathways during respiratory viral infections in airway epithelial cells.
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Affiliation(s)
- Jae Woo Lee
- Department of Pediatrics, Severance Hospital, Institute of Allergy, Brain Korea 21 Project, Yonsei University College of Medicine, 134 Sinchon-Dong, Seoul, 03722, South Korea.
| | - Mi Na Kim
- Department of Pediatrics, Severance Hospital, Institute of Allergy, Brain Korea 21 Project, Yonsei University College of Medicine, 134 Sinchon-Dong, Seoul, 03722, South Korea.
| | - Eun Gyul Kim
- Department of Pediatrics, Severance Hospital, Institute of Allergy, Brain Korea 21 Project, Yonsei University College of Medicine, 134 Sinchon-Dong, Seoul, 03722, South Korea.
| | - Ji Su Leem
- Department of Pediatrics, Severance Hospital, Institute of Allergy, Brain Korea 21 Project, Yonsei University College of Medicine, 134 Sinchon-Dong, Seoul, 03722, South Korea.
| | - Seung Min Baek
- Department of Pediatrics, Severance Hospital, Institute of Allergy, Brain Korea 21 Project, Yonsei University College of Medicine, 134 Sinchon-Dong, Seoul, 03722, South Korea.
| | - Min Jung Kim
- Department of Pediatrics, Yonsei University Yongin Severance Hospital, 363 Dongbaekjukjeon-daero, Giheung-gu, Yongin-si, Gyeonggi-do, 16995, South Korea.
| | - Kyung Won Kim
- Department of Pediatrics, Severance Hospital, Institute of Allergy, Brain Korea 21 Project, Yonsei University College of Medicine, 134 Sinchon-Dong, Seoul, 03722, South Korea.
| | - Myung Hyun Sohn
- Department of Pediatrics, Severance Hospital, Institute of Allergy, Brain Korea 21 Project, Yonsei University College of Medicine, 134 Sinchon-Dong, Seoul, 03722, South Korea.
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Perez MF, Atuegwu NC, Mortensen EM, Oncken C. The inflammatory biomarker YKL-40 is elevated in the serum, but not the sputum, of E-cigarette users. Exp Lung Res 2021; 47:55-66. [PMID: 33200966 PMCID: PMC8168626 DOI: 10.1080/01902148.2020.1847216] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2020] [Revised: 11/02/2020] [Accepted: 11/03/2020] [Indexed: 10/23/2022]
Abstract
METHODS We conducted a cross-sectional study of adults between 18 and 55 years old. Inclusion criteria were: exclusive e-cigarette use or cigarette smoking for ≥ 1 year or no history of tobacco use. Participants with a history of pulmonary illness, atopy, medications (except birth control pills), marijuana, and illegal substance use were excluded. Custom Multiplex ELISA was used to measure YKL-40 and other biomarker levels in the serum and induced sputum of the participants. Multivariable linear regression was used to compare the levels of YLK-40 in healthy participants, e-cigarette, and cigarette users after adjusting for age, sex, and BMI. RESULTS We recruited 20 healthy controls, 23 cigarette smokers, and 22 exclusive e-cigarette users. Serum YKL-40 (ng/ml) was significantly higher in e-cigarette users (Median 21.2 [IQR 12.1-24.0] ng/ml) when compared to controls (12.2 [IQR 8.7-18.1] ng/ml, p = 0.016) but comparable to cigarette smokers (21.6 [IQR 11.62-51.7] ng/ml, p = 0.31). No significant differences were found in the serum or sputum of the other biomarkers tested. CONCLUSION The inflammatory biomarker, YKL-40 is elevated in the serum but not the sputum of e-cigarette users with no reported pulmonary disease. Further research is necessary to characterize this association.
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Affiliation(s)
- Mario F Perez
- Pulmonary, Critical Care and Sleep Medicine, Deparment of Medicine, University of Connecticut School of Medicine, Farmington, CT, USA
| | - Nkiruka C Atuegwu
- Pulmonary, Critical Care and Sleep Medicine, Deparment of Medicine, University of Connecticut School of Medicine, Farmington, CT, USA
| | - Eric M Mortensen
- Pulmonary, Critical Care and Sleep Medicine, Deparment of Medicine, University of Connecticut School of Medicine, Farmington, CT, USA
| | - Cheryl Oncken
- Pulmonary, Critical Care and Sleep Medicine, Deparment of Medicine, University of Connecticut School of Medicine, Farmington, CT, USA
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Harlander M, Lestan D, Turel M. Chitotriosidase Activity in Plasma and COPD Exacerbations. Lung 2020; 198:299-306. [PMID: 31982942 DOI: 10.1007/s00408-020-00331-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2019] [Accepted: 01/20/2020] [Indexed: 11/25/2022]
Abstract
INTRODUCTION This study aimed to determine the association between plasma chitotriosidase activity and the clinical characteristics and exacerbation rate of COPD patients. METHODS The study comprised 97 patients with COPD. Their clinical characteristics and a history of exacerbations in the last 12 months were noted. Plasma chitotriosidase activity was determined. Patients were followed up for 12 months, and the number of moderate and severe exacerbations during this period was recorded. RESULTS Chitotriosidase activity positively correlated with patient age (rho = 0.217, p = 0.036) and inversely with CAT (rho = - 0.240, p = 0.020). There was no correlation with lung function. Chitotriosidase activity was significantly lower in patients with a history of ≥ 2 exacerbations compared to patients without a history of exacerbations (93 [38-312] vs. 264 [168-408] nmol/h/mL, p = 0.033). Overall, there was no difference in chitotriosidase activity between patients with or without observed exacerbations. Patients with a history of ≥ 1 exacerbation and ≥ 1 observed exacerbation had higher chitotriosidase activity compared to patients without further exacerbations (240 [144-456] vs. 52 [39-240] nmol/h/mL, p = 0.035). Multivariate analysis identified FEV1 (HR 0.976, 95% CI 0.956-0.996, p = 0.016) and blood eosinophil percentage (HR 1.222, 95% CI 1.048-1.424, p = 0.011) as independent predictors of future exacerbations in the total patient population, while in patients with a history of ≥ 1 exacerbation ,the only independent predictor was chitotriosidase activity (HR per 10 nmol/h/mL 1.028, 95% CI 1.002-1.055, p = 0.037). CONCLUSION While mixed associations between chitotriosidase activity and clinical outcomes were seen, chitotriosidase activity could be a predictor of future exacerbations in patients with a history of ≥ 1 exacerbation in the past 12 months.
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Affiliation(s)
- Matevz Harlander
- Department of Pulmonary Diseases, University Medical Centre Ljubljana, Zaloška cesta 2, 1000, Ljubljana, Slovenia. .,Faculty of Medicine, University of Ljubljana, Vrazov trg 2, 1000, Ljubljana, Slovenia.
| | - David Lestan
- Department of Pulmonary Diseases, University Medical Centre Ljubljana, Zaloška cesta 2, 1000, Ljubljana, Slovenia
| | - Matjaz Turel
- Department of Pulmonary Diseases, University Medical Centre Ljubljana, Zaloška cesta 2, 1000, Ljubljana, Slovenia
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Majewski S, Tworek D, Szewczyk K, Kiszałkiewicz J, Kurmanowska Z, Brzeziańska-Lasota E, Jerczyńska H, Antczak A, Piotrowski WJ, Górski P. Overexpression of chitotriosidase and YKL-40 in peripheral blood and sputum of healthy smokers and patients with chronic obstructive pulmonary disease. Int J Chron Obstruct Pulmon Dis 2019; 14:1611-1631. [PMID: 31413557 PMCID: PMC6660640 DOI: 10.2147/copd.s184097] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2019] [Accepted: 06/05/2019] [Indexed: 12/21/2022] Open
Abstract
Background Despite the absence of endogenous chitin in humans, chitinases are present in the serum of healthy subjects and their levels are increased in a variety of chronic inflammatory conditions. It has been shown that chitotriosidase and structurally related chitinase-like protein-YKL-40 contribute to the pathogenesis of COPD. However, details regarding the relation of their systemic and local airways levels remain unknown. Objectives To examine peripheral blood and sputum chitotriosidase and YKL-40 expression in smokers and patients with COPD. Methods Forty patients with COPD, 20 healthy smokers and 10 healthy never-smokers were studied. Serum and induced sputum chitotriosidase protein and activity levels, YKL-40 concentrations, and their gene expression in sputum cells and peripheral blood mononuclear cells (PBMC) were evaluated. Results Both chitotriosidase protein levels and activity were higher in sputum obtained from COPD subjects compared to healthy never-smokers (P<0.05 and P<0.01, respectively). A similar pattern was observed for PBMC chitotriosidase mRNA expression (P<0.001). YKL-40 serum concentrations were elevated in healthy smokers and COPD subjects compared to healthy never-smokers (P<0.001 and P<0.01, respectively). In sputum, YKL-40 levels were increased in COPD compared to healthy never-smokers (P<0.01). PBMC YKL-40 mRNA expression was increased in COPD and healthy smokers compared to healthy never-smokers (P<0.0001). No associations were found between chitotriosidase or YKL-40 peripheral blood levels and sputum levels. Conclusions Our results demonstrate that chitotriosidase and YKL-40 are overexpressed in peripheral blood and airways in both healthy smokers and COPD subjects which may indicate smoking-related activation of macrophages, neutrophils, and epithelial cells.
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Affiliation(s)
- Sebastian Majewski
- Department of Pneumology and Allergy, Medical University of Lodz, Lodz, Poland
| | - Damian Tworek
- Department of General and Oncological Pulmonology, Medical University of Lodz, Lodz, Poland
| | - Karolina Szewczyk
- Department of Pneumology and Allergy, Medical University of Lodz, Lodz, Poland
| | | | - Zofia Kurmanowska
- Department of Pneumology and Allergy, Medical University of Lodz, Lodz, Poland
| | | | - Hanna Jerczyńska
- Central Scientific Laboratory (CoreLab), Medical University of Lodz, Lodz, Poland
| | - Adam Antczak
- Department of General and Oncological Pulmonology, Medical University of Lodz, Lodz, Poland
| | | | - Paweł Górski
- Department of Pneumology and Allergy, Medical University of Lodz, Lodz, Poland
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Javath Hussain S, Selvaraj J, Mohanty Mohapatra M, Rajendiran S. Clinical utility of pleural fluid YKL-40 as a marker of malignant pleural effusion. Curr Probl Cancer 2018; 43:354-362. [PMID: 30471784 DOI: 10.1016/j.currproblcancer.2018.10.001] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2018] [Accepted: 10/11/2018] [Indexed: 01/25/2023]
Abstract
Pleural effusion is a common presenting feature of malignancy. Malignant pleural effusion is primarily diagnosed by pleural fluid cytology, pleural biopsy, and tumor markers. The glycoprotein YKL-40 is a new tumor marker that has shown to have a good diagnostic accuracy to detect malignant pleural effusion. However, there are only a few studies that have evaluated pleural fluid YKL-40 for detecting malignant pleural effusions. Hence, we conducted this study to evaluate the utility of pleural fluid YKL-40 to detect malignant pleural effusion. This is a cross-sectional study conducted between February 2016 and December 2017 in a tertiary care referral hospital. One hundred and forty-seven consecutive patients with pleural effusion were included in the study. These patients were divided into 3 groups, viz malignant, tuberculous, and parapneumonic pleural effusion, based on clinical features, radiological examination, and pleural fluid analysis. Pleural fluid YKL-40 levels were measured using enzyme-linked immunosorbent assay. Out of the 147 consecutive patients included in the study, 47 patients (31.97%) had malignant pleural effusion, 51 patients (34.69%) had tuberculous pleural effusion, and 49 patients (33.33%) had parapneumonic pleural effusion. The median pleural fluid YKL-40 level was higher in malignant pleural effusion (114.80 ng/mL) compared to tuberculous (93.17 ng/mL) and parapneumonic pleural effusion (89.87 ng/mL; P < 0.05). A diagnostic cut-off for pleural fluid YKL-40 value of 99.76 ng/mL detected malignant pleural effusion with 83% sensitivity, 87% specificity, positive predictive value (PPV) of 75%, negative predictive value (NPV) of 91.58%, and diagnostic accuracy of 85.71%. The level of pleural fluid YKL-40 is significantly elevated in malignant pleural effusion. In lymphocytic pleural effusions presenting with low adenosine deaminase levels and high YKL-40 levels, a thorough diagnostic search for malignancy is warranted.
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Tong X, Wang D, Liu S, Ma Y, Li Z, Tian P, Fan H. The YKL-40 protein is a potential biomarker for COPD: a meta-analysis and systematic review. Int J Chron Obstruct Pulmon Dis 2018; 13:409-418. [PMID: 29430175 PMCID: PMC5796800 DOI: 10.2147/copd.s152655] [Citation(s) in RCA: 40] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
Abstract
Background Many studies have found that YKL-40 may play an important pathogenic role in COPD. However, the results of these studies were inconsistent. Therefore, we performed a systematic review and meta-analysis to investigate the role of YKL-40 in COPD. Methods We performed a systematic literature search in many database and commercial internet search engines to identify studies involving the role of YKL-40 in patients with COPD. The standardized mean difference (SMD) and Fisher’s Z-value with its 95% confidence interval (CI) were used to investigate the effect sizes. Results A total of 15 eligible articles including 16 case–control/cohort groups were included in the meta-analysis. The results indicated that the serum YKL-40 levels in patients with COPD were significantly higher than those in healthy controls (SMD =1.58, 95% CI =0.68–2.49, P=0.001), and it was correlated with lung function (pooled r=−0.32; Z=−0.33; P<0.001). The results of subgroup analysis found that the serum YKL-40 levels were statistically different between the exacerbation group and the stable group in patients with COPD (SMD =1.55, 95% CI =0.81–2.30, P<0.001). Moreover, the results indicated that the sputum YKL-40 levels in patients with COPD were also significantly higher than those in healthy controls (SMD =0.70, 95% CI =0.10–1.30, P=0.022). Conclusion The current study suggests that YKL-40 may be implicated in bronchial inflammation and remodeling in COPD and may be considered as a useful biomarker for COPD diagnosis and monitoring.
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Affiliation(s)
- Xiang Tong
- Department of Respiratory and Critical Care Medicine, West China Hospital/West China School of Medicine, Sichuan University, Chengdu, People's Republic of China
| | - Dongguang Wang
- Department of Respiratory and Critical Care Medicine, West China Hospital/West China School of Medicine, Sichuan University, Chengdu, People's Republic of China
| | - Sitong Liu
- Department of Respiratory and Critical Care Medicine, West China Hospital/West China School of Medicine, Sichuan University, Chengdu, People's Republic of China
| | - Yao Ma
- Department of Respiratory and Critical Care Medicine, West China Hospital/West China School of Medicine, Sichuan University, Chengdu, People's Republic of China.,The Center of Gerontology and Geriatrics, West China Hospital/West China School of Medicine, Sichuan University, Chengdu, People's Republic of China
| | - Zhenzhen Li
- Health Management Center, West China Hospital/West China School of Medicine, Sichuan University, Chengdu, People's Republic of China
| | - Panwen Tian
- Department of Respiratory and Critical Care Medicine, West China Hospital/West China School of Medicine, Sichuan University, Chengdu, People's Republic of China.,Lung Cancer Center, West China Hospital/West China School of Medicine, Sichuan University, Chengdu, People's Republic of China
| | - Hong Fan
- Department of Respiratory and Critical Care Medicine, West China Hospital/West China School of Medicine, Sichuan University, Chengdu, People's Republic of China
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Spoorenberg SMC, Vestjens SMT, Voorn GP, van Moorsel CHM, Meek B, Zanen P, Rijkers GT, Bos WJW, Grutters JC. Course of SP-D, YKL-40, CCL18 and CA 15-3 in adult patients hospitalised with community-acquired pneumonia and their association with disease severity and aetiology: A post-hoc analysis. PLoS One 2018; 13:e0190575. [PMID: 29324810 PMCID: PMC5764260 DOI: 10.1371/journal.pone.0190575] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2017] [Accepted: 11/23/2017] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND AND AIM SP-D, YKL-40, CCL18 and CA 15-3 are pulmonary markers that have been extensively investigated in different chronic pulmonary diseases. However, in acute pulmonary diseases, such as community-acquired pneumonia (CAP), little is known about the course of these markers and their relationship with the aetiological agent. The aim of this study was to investigate the course of these four markers in CAP and to study influence of disease severity, aetiology and antibiotic use prior to admission on their course. METHODS We included 291 adult patients hospitalised with CAP and 20 healthy controls. Measurements were performed in serum of day 0, 2, and 4, and at least 30 days after admission. RESULTS Our most important results were: 1) At all time-points, including 30 days after admission, YKL-40 and CCL18 levels were higher in CAP patients compared to healthy controls; and 2) Patients with CAP caused by an intracellular, atypical bacterium had lower YKL-40 and especially CCL18 levels on and during admission in comparison with other or unknown CAP aetiology. CONCLUSIONS Our findings suggest that these pulmonary markers could be useful to assess CAP severity and, especially YKL-40 and CCL18 by helping predict CAP caused by atypical pathogens.
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Affiliation(s)
| | | | - G. P. Voorn
- Department of Medical Microbiology and Immunology, St Antonius Hospital, Nieuwegein, The Netherlands
| | - Coline H. M. van Moorsel
- Department of Pulmonology, St Antonius Hospital, Nieuwegein, The Netherlands
- Division of Heart and Lungs, University Medical Centre Utrecht, Utrecht, The Netherlands
| | - Bob Meek
- Department of Medical Microbiology and Immunology, St Antonius Hospital, Nieuwegein, The Netherlands
| | - Pieter Zanen
- Division of Heart and Lungs, University Medical Centre Utrecht, Utrecht, The Netherlands
| | - Ger T. Rijkers
- Department of Medical Microbiology and Immunology, St Antonius Hospital, Nieuwegein, The Netherlands
- Department of Sciences, Roosevelt Academy, Middelburg, The Netherlands
| | - Willem Jan W. Bos
- Department of Internal Medicine, St Antonius Hospital, Nieuwegein, The Netherlands
| | - Jan C. Grutters
- Department of Pulmonology, St Antonius Hospital, Nieuwegein, The Netherlands
- Division of Heart and Lungs, University Medical Centre Utrecht, Utrecht, The Netherlands
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Guo W, Wang J, Wei H. Serum YKL-40 Level Positively Correlates With Uterine Leiomyomas. Reprod Sci 2016; 23:1559-1564. [DOI: 10.1177/1933719116648219] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Affiliation(s)
- Wenping Guo
- Department of Gynecology and Obstetrics, Peking University International Hospital, Beijing, China
| | - Jing Wang
- Department of Gynecology and Obstetrics, Peking University International Hospital, Beijing, China
| | - Hongyi Wei
- Department of Gynecology and Obstetrics, Peking University International Hospital, Beijing, China
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Leonardi S, Parisi GF, Capizzi A, Manti S, Cuppari C, Scuderi MG, Rotolo N, Lanzafame A, Musumeci M, Salpietro C. YKL-40 as marker of severe lung disease in cystic fibrosis patients. J Cyst Fibros 2016; 15:583-6. [PMID: 26778616 DOI: 10.1016/j.jcf.2015.12.020] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2015] [Revised: 12/19/2015] [Accepted: 12/22/2015] [Indexed: 10/22/2022]
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James AJ, Reinius LE, Verhoek M, Gomes A, Kupczyk M, Hammar U, Ono J, Ohta S, Izuhara K, Bel E, Kere J, Söderhäll C, Dahlén B, Boot RG, Dahlén SE. Increased YKL-40 and Chitotriosidase in Asthma and Chronic Obstructive Pulmonary Disease. Am J Respir Crit Care Med 2016; 193:131-42. [PMID: 26372680 DOI: 10.1164/rccm.201504-0760oc] [Citation(s) in RCA: 90] [Impact Index Per Article: 11.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
RATIONALE Serum chitinases may be novel biomarkers of airway inflammation and remodeling, but less is known about factors regulating their levels. OBJECTIVES To examine serum chitotriosidase activity and YKL-40 levels in patients with asthma and chronic obstructive pulmonary disease (COPD) and evaluate clinically relevant factors that may affect chitinase levels, including genetic variability, corticosteroid treatment, disease exacerbations, and allergen exposure. METHODS Serum chitotriosidase (CHIT1) activity and YKL-40 (CHI3L1) levels, as well as the CHIT1 rs3831317 and CHI3L1 rs4950928 genotypes, were examined in subsets of patients with mild to moderate asthma (n = 76), severe asthma (n = 93), and COPD (n = 64) taking part in the European multicenter BIOAIR (Longitudinal Assessment of Clinical Course and Biomarkers in Severe Chronic Airway Disease) study. Blood was obtained at baseline, before and after a 2-week oral steroid intervention, up to six times during a 1-year period, and during exacerbations. Baseline chitinase levels were also measured in 72 healthy control subjects. The effect of allergen inhalation on blood and sputum YKL-40 levels was measured in two separate groups of patients with mild atopic asthma; one group underwent repeated low-dose allergen challenge (n = 15), and the other underwent high-dose allergen challenge (n = 16). MEASUREMENTS AND MAIN RESULTS Serum chitotriosidase and YKL-40 were significantly elevated in patients with asthma and those with COPD compared with healthy control subjects. Genotype and age strongly affected both YKL-40 and chitotriosidase activity, but associations with disease remained following adjustment for these factors. Correlations were observed with lung function but not with other biomarkers, including exhaled nitric oxide, blood eosinophils, periostin, and IgE. Generally, acute exacerbations, allergen-induced airway obstruction, and corticosteroid treatment did not affect circulating chitinase levels. CONCLUSIONS YKL-40 and chitotriosidase are increased in asthma and more so in COPD. The data in the present study support these substances as being relatively steroid-insensitive, non-T-helper cell type 2-type biomarkers distinctly related to chronic inflammatory disease processes.
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Affiliation(s)
- Anna J James
- 1 Institute of Environmental Medicine.,2 Center for Allergy Research
| | - Lovisa E Reinius
- 2 Center for Allergy Research.,3 Center for Innovative Medicine, and.,4 Department of Biosciences and Nutrition, Karolinska Institutet, Stockholm, Sweden
| | - Marri Verhoek
- 5 Department of Biochemistry, Leiden Institute of Chemistry, Leiden University, Leiden, the Netherlands
| | - Anna Gomes
- 1 Institute of Environmental Medicine.,2 Center for Allergy Research
| | - Maciej Kupczyk
- 1 Institute of Environmental Medicine.,2 Center for Allergy Research
| | | | - Junya Ono
- 6 Shino-Test Corporation, Sagamihara, Japan
| | | | - Kenji Izuhara
- 8 Division of Medical Biochemistry, Department of Biomolecular Sciences, Saga Medical School, Saga University, Saga, Japan
| | - Elisabeth Bel
- 9 Department of Pulmonology, Academic Medical Center, University of Amsterdam, Amsterdam, the Netherlands; and
| | - Juha Kere
- 2 Center for Allergy Research.,3 Center for Innovative Medicine, and.,4 Department of Biosciences and Nutrition, Karolinska Institutet, Stockholm, Sweden
| | - Cilla Söderhäll
- 2 Center for Allergy Research.,3 Center for Innovative Medicine, and.,4 Department of Biosciences and Nutrition, Karolinska Institutet, Stockholm, Sweden
| | - Barbro Dahlén
- 2 Center for Allergy Research.,10 Department of Medicine, Karolinska University Hospital, Huddinge, Stockholm, Sweden
| | - Rolf G Boot
- 5 Department of Biochemistry, Leiden Institute of Chemistry, Leiden University, Leiden, the Netherlands
| | - Sven-Erik Dahlén
- 1 Institute of Environmental Medicine.,2 Center for Allergy Research
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13
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Kzhyshkowska J, Gudima A, Moganti K, Gratchev A, Orekhov A. Perspectives for Monocyte/Macrophage-Based Diagnostics of Chronic Inflammation. Transfus Med Hemother 2016; 43:66-77. [PMID: 27226789 DOI: 10.1159/000444943] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2016] [Accepted: 02/22/2016] [Indexed: 12/17/2022] Open
Abstract
Low-grade chronic inflammation underlies the development of the most dangerous cardiometabolic disorders including type 2 diabetes and its vascular complications. In contrast to acute inflammation induced by bacteria and viruses, chronic inflammation can be driven by abnormal reaction to endogenous factors, including Th2 cytokines, metabolic factors like advanced glycation end products (AGEs), modified lipoproteins, or hyperglycemia. The key innate immune cells that recognize these factors in blood circulation are monocytes. Inflammatory programming of monocytes which migrate into tissues can, in turn, result into generation of tissue macrophages with pathological functions. Therefore, determination of the molecular and functional phenotype of circulating monocytes is a very promising diagnostic tool for the identification of hidden inflammation, which can precede the development of the pathology. Here we propose a new test system for the identification of inflammatory programming of monocytes: surface biomarkers and ex vivo functional system. We summarize the current knowledge about surface biomarkers for monocyte subsets, including CD16, CCR2, CX3CR1, CD64, stabilin-1 and CD36, and their association with inflammatory human disorders. Furthermore, we present the design of an ex vivo monocyte-based test system with minimal set of parameters as a potential diagnostic tool for the identification of personalized inflammatory responses.
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Affiliation(s)
- Julia Kzhyshkowska
- Institute of Transfusion Medicine and Immunology, Medical Faculty Mannheim, University of Heidelberg, Mannheim, Germany; Red Cross Blood Service Baden-Württemberg-Hessen, Mannheim, Germany; Laboratory for Translational Cellular and Molecular Biomedicine, Tomsk State University, Tomsk, Russia
| | - Alexandru Gudima
- Institute of Transfusion Medicine and Immunology, Medical Faculty Mannheim, University of Heidelberg, Mannheim, Germany
| | - Kondaiah Moganti
- Institute of Transfusion Medicine and Immunology, Medical Faculty Mannheim, University of Heidelberg, Mannheim, Germany
| | - Alexei Gratchev
- Laboratory for Translational Cellular and Molecular Biomedicine, Tomsk State University, Tomsk, Russia
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14
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Regulation of YKL-40 expression by corticosteroids: effect on pro-inflammatory macrophages in vitro and its modulation in COPD in vivo. Respir Res 2015; 16:154. [PMID: 26696093 PMCID: PMC4699377 DOI: 10.1186/s12931-015-0314-3] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2015] [Accepted: 12/15/2015] [Indexed: 12/15/2022] Open
Abstract
Background Macrophages constitute a heterogeneous cell population with pro- (MΦ1) and anti-inflammatory (MΦ2) cells. The soluble chitinase-like-protein YKL-40 is expressed in macrophages and various other cell types, and has been linked to a variety of inflammatory diseases, including COPD. Dexamethasone strongly reduces YKL-40 expression in peripheral blood mononuclear cells (PBMC) in vitro. We hypothesized that: a) YKL-40 is differentially expressed by MΦ1 and MΦ2, b) is decreased by corticosteroids and c) that long-term treatment with inhaled corticosteroids (ICS) affects YKL-40 levels in serum and sputum of COPD patients. Methods Monocytes of healthy subjects were cultured in vitro for 7 days with either GM-CSF or M-CSF (for MΦ1 and MΦ2, respectively) and stimulated for 24 h with LPS, TNFα, or oncostatin M (OSM). MΦ1 and MΦ2 differentiation was assessed by measuring secretion of IL-12p40 and IL-10, respectively. YKL-40 expression in macrophages was measured by quantitative RT-PCR (qPCR) and ELISA; serum and sputum YKL-40 levels were analyzed by ELISA. Results Pro-inflammatory MΦ1 cells secreted significantly more YKL-40 than MΦ2, which was independent of stimulation with LPS, TNFα or OSM (p < 0.001) and confirmed by qPCR. Dexamethasone dose-dependently and significantly inhibited YKL-40 protein and mRNA levels in MΦ1. Serum YKL-40 levels of COPD patients were significantly higher than sputum YKL-40 levels but were not significantly changed by ICS treatment. Conclusions YKL-40 secretion from MΦ1 cells is higher than from MΦ2 cells and is unaffected by further stimulation with pro-inflammatory agents. Furthermore, YKL-40 release from cultured monocyte-derived macrophages is inhibited by dexamethasone especially in MΦ1, but ICS treatment did not change YKL-40 serum and sputum levels in COPD. These results indicate that YKL-40 expression could be used as a marker for MΦ1 macrophages in vitro, but not for monitoring the effect of ICS in COPD. Trial registration ClinicalTrials.gov, registration number: NCT00158847
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15
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Magnetic bead fluorescent immunoassay for the rapid detection of the novel inflammation marker YKL40 at the point-of-care. J Immunol Methods 2015; 427:36-41. [DOI: 10.1016/j.jim.2015.09.004] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2015] [Revised: 08/21/2015] [Accepted: 09/23/2015] [Indexed: 11/19/2022]
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16
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Libreros S, Iragavarapu-Charyulu V. YKL-40/CHI3L1 drives inflammation on the road of tumor progression. J Leukoc Biol 2015; 98:931-6. [PMID: 26310833 DOI: 10.1189/jlb.3vmr0415-142r] [Citation(s) in RCA: 62] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2015] [Accepted: 08/05/2015] [Indexed: 12/12/2022] Open
Abstract
Inflammation plays a vital role at different stages of tumor progression. The development of tumors is affected by inflammatory mediators produced by the tumor and the host. YKL-40/chitinase-3-like-1 protein is often up-regulated in inflammation-associated diseases. With the use of chronic inflammatory disease systems, we describe the role of YKL-40/chitinase-3-like-1 protein in enhancing the inflammatory response and its implications in tumorigenesis. We also discuss how pre-existing inflammation enhances tumor growth and metastasis. In this mini-review, we highlight the effect of YKL-40/chitinase-3-like-1 protein-associated inflammation in promoting tumor progression.
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Affiliation(s)
- Stephania Libreros
- Department of Biomedical Sciences, College of Medicine, Florida Atlantic University, Boca Raton, Florida, USA
| | - Vijaya Iragavarapu-Charyulu
- Department of Biomedical Sciences, College of Medicine, Florida Atlantic University, Boca Raton, Florida, USA
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17
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Sørensen AK, Holmgaard DB, Mygind LH, Johansen J, Pedersen C. Neutrophil-to-lymphocyte ratio, calprotectin and YKL-40 in patients with chronic obstructive pulmonary disease: correlations and 5-year mortality - a cohort study. JOURNAL OF INFLAMMATION-LONDON 2015; 12:20. [PMID: 25908927 PMCID: PMC4407303 DOI: 10.1186/s12950-015-0064-5] [Citation(s) in RCA: 41] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/28/2014] [Accepted: 02/27/2015] [Indexed: 12/14/2022]
Abstract
Background Chronic obstructive pulmonary disease (COPD) is characterized by chronic inflammation and progressive decline in pulmonary function. Neutrophil-to-lymphocyte ratio (NLR), YKL-40 and calprotectin are biomarkers of inflammation and predict mortality in patients with different inflammatory diseases. We aimed to investigate the correlation between levels of these three biomarkers and neutrophil granulocyte and lymphocyte count in patients with moderate to very severe COPD stratified by use of systemic glucocorticoids. Furthermore, we studied the ability of these biomarkers to predict all-cause mortality. Methods 386 patients with moderate to very severe COPD were followed prospectively for 10 years. Patients were divided into two groups according to systemic glucocorticoid use at baseline. Correlations between biomarkers were assessed by Spearman’s Rho, and mortality was evaluated in uni- and multivariate Cox regression analyses with hazard ratios (HR) and 95% confidence intervals (CI). Results Plasma calprotectin was positively correlated with neutrophil granulocyte count and NLR. No significant association was found between plasma YKL-40 and the cellular biomarkers, irrespective of glucocorticoid treatment. In the group not treated with systemic glucocorticoids, plasma calprotectin [HR 1.002 (95% CI 1.000 – 1.004)], NLR [HR 1.090 (1.036 – 1.148)] and lymphocyte count [HR 0.667 (0.522 – 0.851)] were significantly associated with higher mortality. In the group treated with systemic glucocorticoids, higher plasma YKL-40 was significantly associated with mortality in univariate Cox regression analysis [HR 1.006 (1.003 – 1.008)]. Conclusions Calprotectin was related to neutrophil granulocyte count and NLR in patients with moderate to very severe COPD in stable phase and not in treatment with systemic glucocorticoids. Lymphopenia, higher plasma calprotectin and higher NLR were independent predictors of increased all-cause mortality in this group. Our data also suggests that treatment with systemic glucocorticoids has a significant impact on the ability of inflammatory biomarkers to predict all-cause mortality. Trial registration ClinicalTrials.gov NCT00132860.
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Affiliation(s)
| | | | - Lone Hagens Mygind
- Department of Infectious Diseases, Aalborg University Hospital, Aalborg, Denmark
| | - Julia Johansen
- Departments of Medicine and Oncology, Herlev Hospital, University of Copenhagen, Copenhagen, Denmark
| | - Court Pedersen
- Department of Infectious Diseases Q, Odense University Hospital, Odense, Denmark
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18
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Lai T, Chen M, Deng Z, L Y, Wu D, Li D, Wu B. YKL-40 is correlated with FEV1 and the asthma control test (ACT) in asthmatic patients: influence of treatment. BMC Pulm Med 2015; 15:1. [PMID: 25578181 PMCID: PMC4417200 DOI: 10.1186/1471-2466-15-1] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2013] [Accepted: 01/06/2015] [Indexed: 11/28/2022] Open
Abstract
Background YKL-40 is also called chitinase-3-like-1 (CHI3L1) protein and may be a marker for asthma. The aims of the present study were to investigate whether serum YKL-40 levels are stable or decreased in patients with asthma after appropriate treatment and to evaluate the correlation of YKL-40 levels with lung function and asthma control test (ACT) results. Methods A total of 103 asthmatic patients (mean age 33.1 ± 0.9 years) with diagnosed asthma were enrolled in our study. All patients underwent a detailed clinical examination and completed the ACT questionnaire, serum YKL-40 measurement, and spirometry before (visit 1) and 8 weeks after initiation of treatment (visit 2). Results At the follow-up, the median serum YKL-40 level was significantly decreased compared to the levels at visit 1 (75.2 [55.8-86.8] ng/ml versus 54.5 [46.4-58.4] ng/ml, p < 0.001). The serum YKL-40 level was negatively correlated with %FEV1 (r = -0.37, p < 0.001) and ACT score (r = -0.26, p = 0.007) at visit 1. The change in serum YKL-40 levels between the visits was significantly correlated with changes in FEV1 (r = -0.28, p = 0.006) and ACT score (r = -0.22, p = 0.037). Patients with elevated YKL-40 levels had significantly greater corticosteroid use than patients with lower levels. Conclusions YKL-40 was reduced in the serum of asthmatic patients after appropriate treatment, and the levels correlated with improvements in %FEV1 and ACT. High levels of serum YKL-40 may be refractory to current asthma treatments. Trial registration ChiCTR-OCC-13003316 Electronic supplementary material The online version of this article (doi:10.1186/1471-2466-15-1) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Tianwen Lai
- Department of Respiratory and Critical Care Medicine, Institute of Respiratory Diseases, Affiliated Hospital, Guangdong Medicine College, Zhanjiang, 524000, China.
| | - Min Chen
- Department of Respiratory and Critical Care Medicine, Institute of Respiratory Diseases, Affiliated Hospital, Guangdong Medicine College, Zhanjiang, 524000, China.
| | - Zaichun Deng
- Department of Respiratory Medicine, Affiliated Hospital of School of Medicine, Ningbo University, Ningbo, 315020, China.
| | - Yingying L
- Department of Respiratory and Critical Care Medicine, Institute of Respiratory Diseases, Affiliated Hospital, Guangdong Medicine College, Zhanjiang, 524000, China.
| | - Dong Wu
- Department of Respiratory and Critical Care Medicine, Institute of Respiratory Diseases, Affiliated Hospital, Guangdong Medicine College, Zhanjiang, 524000, China.
| | - Dongming Li
- Department of Respiratory and Critical Care Medicine, Institute of Respiratory Diseases, Affiliated Hospital, Guangdong Medicine College, Zhanjiang, 524000, China.
| | - Bin Wu
- Department of Respiratory and Critical Care Medicine, Institute of Respiratory Diseases, Affiliated Hospital, Guangdong Medicine College, Zhanjiang, 524000, China.
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19
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Shaw JG, Vaughan A, Dent AG, O'Hare PE, Goh F, Bowman RV, Fong KM, Yang IA. Biomarkers of progression of chronic obstructive pulmonary disease (COPD). J Thorac Dis 2014; 6:1532-47. [PMID: 25478195 DOI: 10.3978/j.issn.2072-1439.2014.11.33] [Citation(s) in RCA: 67] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2014] [Accepted: 11/21/2014] [Indexed: 01/02/2023]
Abstract
Disease progression of chronic obstructive pulmonary disease (COPD) is variable, with some patients having a relatively stable course, while others suffer relentless progression leading to severe breathlessness, frequent acute exacerbations of COPD (AECOPD), respiratory failure and death. Radiological markers such as CT emphysema index, bronchiectasis and coronary artery calcification (CAC) have been linked with increased mortality in COPD patients. Molecular changes in lung tissue reflect alterations in lung pathology that occur with disease progression; however, lung tissue is not routinely accessible. Cell counts (including neutrophils) and mediators in induced sputum have been associated with lung function and risk of exacerbations. Examples of peripheral blood biological markers (biomarkers) include those associated with lung function (reduced CC-16), emphysema severity (increased adiponectin, reduced sRAGE), exacerbations and mortality [increased CRP, fibrinogen, leukocyte count, IL-6, IL-8, and tumor necrosis factor α (TNF-α)] including increased YKL-40 with mortality. Emerging approaches to discovering markers of gene-environment interaction include exhaled breath analysis [volatile organic compounds (VOCs), exhaled breath condensate], cellular and systemic responses to exposure to air pollution, alterations in the lung microbiome, and biomarkers of lung ageing such as telomere length shortening and reduced levels of sirtuins. Overcoming methodological challenges in sampling and quality control will enable more robust yet easily accessible biomarkers to be developed and qualified, in order to optimise personalised medicine in patients with COPD.
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Affiliation(s)
- Janet G Shaw
- 1 Department of Thoracic Medicine, The Prince Charles Hospital, Brisbane, Australia ; 2 UQ Thoracic Research Centre, School of Medicine, the University of Queensland, Brisbane, Australia
| | - Annalicia Vaughan
- 1 Department of Thoracic Medicine, The Prince Charles Hospital, Brisbane, Australia ; 2 UQ Thoracic Research Centre, School of Medicine, the University of Queensland, Brisbane, Australia
| | - Annette G Dent
- 1 Department of Thoracic Medicine, The Prince Charles Hospital, Brisbane, Australia ; 2 UQ Thoracic Research Centre, School of Medicine, the University of Queensland, Brisbane, Australia
| | - Phoebe E O'Hare
- 1 Department of Thoracic Medicine, The Prince Charles Hospital, Brisbane, Australia ; 2 UQ Thoracic Research Centre, School of Medicine, the University of Queensland, Brisbane, Australia
| | - Felicia Goh
- 1 Department of Thoracic Medicine, The Prince Charles Hospital, Brisbane, Australia ; 2 UQ Thoracic Research Centre, School of Medicine, the University of Queensland, Brisbane, Australia
| | - Rayleen V Bowman
- 1 Department of Thoracic Medicine, The Prince Charles Hospital, Brisbane, Australia ; 2 UQ Thoracic Research Centre, School of Medicine, the University of Queensland, Brisbane, Australia
| | - Kwun M Fong
- 1 Department of Thoracic Medicine, The Prince Charles Hospital, Brisbane, Australia ; 2 UQ Thoracic Research Centre, School of Medicine, the University of Queensland, Brisbane, Australia
| | - Ian A Yang
- 1 Department of Thoracic Medicine, The Prince Charles Hospital, Brisbane, Australia ; 2 UQ Thoracic Research Centre, School of Medicine, the University of Queensland, Brisbane, Australia
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