The relationship between serum levels of surfactant protein D in COPD exacerbation severity and mortality

Fatma Esra GÜNAYDIN,Gülşah Günlüoğlu,Sedat ALTIN,Barış DEMİRKOL,Nurdan Kalkan,Esma Nur Aktepe

doi:10.3906/sag-1809-6

Abstract

Background/aim Chronic obstructive pulmonary disease (COPD) is a major cause of morbidity and mortality. In COPD patients, various inflammatory markers such as cytokines and acute phase proteins, which show systemic inflammation in the circulation, increase during exacerbations. In our study, we aimed to determine the relationship between serum SP-D levels and exacerbation severity, clinical course of the disease, and early mortality after discharge.Materials and methods Fifty hospitalized patients with COPD acute exacerbation (46 male and 4 female) were recruited in this study. Thirty-three of the subjects (31 male and 2 female) were reevaluated after discharge. Venous blood samples were taken from all patients and followed up for exacerbation frequency, hospital admission, and mortality for 12 months.Results Serum SP-D levels in the stable period of the patients were lower than exacerbation (P < 0.001). The median exacerbation period SP-D level of the patients admitted to emergency department in the first month was statistically significantly higher than that of the patients who were not admitted (P < 0.05) after discharge. There was a correlation between the rate of emergency admission and serum SP-D levels during the 12-month period after discharge (P = 0.04 (r = 0.29)).Conclusion Our study showed that serum SP-D was found to be a useful biomarker in predicting emergency admission and predictor of the health status of COPD patients but did not predict early mortality after the exacerbation.

Highlights

Chronic obstructive pulmonary disease (COPD) is one of the major causes of morbidity and mortality worldwide [1,2]
Our study showed that serum Surfactant protein D (SP-D) was found to be a useful biomarker in predicting emergency admission and predictor of the health status of COPD patients but did not predict early mortality after the exacerbation
Characteristics of the subjects Fifty hospitalized patients with COPD acute exacerbation (AECOPD group composed of 46 male and 4 female) were recruited in this study

Summary

Introduction

Chronic obstructive pulmonary disease (COPD) is one of the major causes of morbidity and mortality worldwide [1,2]. COPD had been defined as a pulmonary disease characterized by progressive airflow limitation, whereas it has recently been observed that airflow limitation is associated with abnormal inflammatory response and is limited to have effects on the lungs and has systemic effects. A COPD exacerbation is defined as ‘acute worsening of respiratory symptoms in a way that results in the need for additional treatment’ [1]. It negatively affects the state of health, hospital admission, Surfactant protein D (SP-D), a member of the collagendependent C-type lectins or collectins, is a large hydrophilic protein synthesized by collagenous glycoprotein in Type 2 pneumocytes [5]. Increase in the serum level is observed in cases with pulmonary fibrosis, asthma, and ARDS, which progress with chronic inflammation in smokers [6]

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