Abstract
SummaryBackgroundMean platelet volume (MPV), neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR) have all been investigated as novel inflammatory markers of cardiac and oncological diseases, while there is only a limited number of studies investigating these markers in chronic obstructive pulmonary disease (COPD). In the present study we examine NLR, PLR; and other markers, such as eosinophil, MPV, plateletcrit (PCT), platelet distribution width (PDW), red cell distribution width (RDW), and C-reactive protein (CRP) in patients with stable and acute exacerbation of COPD.MethodsStable COPD (Group 1, n=140), COPD with acute exacerbation (Group 2, n=110), and healthy controls (Group 3, n=50) were included in the study. Leukocyte, CRP, hemoglobin (HB), RDW, platelet, MPV, PCT, PDW, neutrophil, lymphocyte, eosinophil, NLR, and PLR were analyzed in all groups.ResultsHB, leukocyte, platelet, neutrophil, eosinophil, MPV, PCT, CRP, NLR, and PLR were significantly higher, while the lymphocyte was lower in Group 1 than in Group 3. Leukocyte, neutrophil, RDW, CRP, NLR, and PLR were significantly higher, while lymphocyte was lower in Group 2 than in Group 3. Leukocyte, neutrophil, RDW, CRP, NLR, and PLR were significantly higher, while HB, platelet, MPV, PCT, and lymphocyte were significantly lower in Group 2 than in Group 1. NLR and PLR increased significantly in patients with bronchiectasis when compared to those without in Group 1.ConclusionsOur study results suggest that NLR, PLR and RDW can be used as simple and cost-effective markers for the evaluation of severity of exacerbation and for predicting hospitalization and further exacerbations in patients with COPD.
Highlights
Chronic obstructive pulmonary disease (COPD), which is characterized by a chronic inflammatory response of the airways and lungs to noxious gas and particles along with progressive and irreversible airflow limitation, is a preventable and treatable condition [1]
Our study results suggest that neutrophil-tolymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR) and red cell distribution width (RDW) can be used as simple and cost-effective markers for the evaluation of severity of exacerbation and for predicting hospitalization and further exacerbations in patients with chronic obstructive pulmonary disease (COPD)
We examine the role of inflammatory and biomarkers [such as leukocyte, eosinophil, C-reactive protein (CRP), NLR, PLR, Mean platelet volume (MPV), plateletcrit (PCT), platelet distribution width (PDW) and hemoglobin (Hb), and red cell distribution width (RDW)] in patients with stable and acute exacerbation of chronic obstructive pulmonary disease (COPD)
Summary
Chronic obstructive pulmonary disease (COPD), which is characterized by a chronic inflammatory response of the airways and lungs to noxious gas and particles along with progressive and irreversible airflow limitation, is a preventable and treatable condition [1]. Pulmonary inflammation results in the entry of cytokines including tumor necrosis factor-alpha (TNFa), interleukin (IL)-1 , IL-6, and IL-8 into the systemic circulation, leading to such increased acute phase proteins as CRP, fibrinogen, serum amyloid A, and surfactant protein D [3]. This increase is more prominent during exacerbations [4]. In COPD exacerbations, tracheobronchial infections account for 50–70% of cases (bacterial causatives 40–50%, viral causatives 30–40%, and atypical bacterial causatives 5–10%), while air pollution accounts for 10% of cases; the etiology remains unknown in about 30% of cases [5] In such cases, the aforementioned markers are useful for identifying and evaluating exacerbation severity. Leukocyte count and CRP, as inflammatory markers in the blood increase during exacerbations, the use of these markers is limited in the differential diagnosis of infectious and non-infectious exacerbations [6]
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