Abstract
Chronic obstructive pulmonary disease (COPD) is a complex and heterogeneous disease, with oxidative stress and inflammation implicated in its development. Uric acid (UA) could exert anti-oxidative, pro-oxidative or pro-inflammatory effects, depending on the specific context. It was recently shown that soluble UA, and not just its crystals, could activate the nucleotide-binding oligomerization domain-like receptor family pyrin domain-containing 3 (NLRP3) inflammasome, leading to interleukin (IL)-1β secretion. We aimed to assess the differences in blood levels of UA and its ratio with creatinine (UCR) between COPD patients and healthy subjects, as well as their association with disease severity, smoking status, common COPD comorbidities and therapy regimes. The diagnostic characteristics of UA and UCR were also explored. This study included 109 stable COPD patients and 95 controls and measured white blood cells (WBC), C-reactive protein (CRP), fibrinogen (Fbg), IL-1β, creatinine (CREAT) and UA. All of the parameters were increased in COPD patients, except for CREAT. UA and UCR were positively associated with WBC, CRP and IL-1β. COPD smokers had lower UA and UCR values. Common COPD therapy did not affect UA or UCR, while patients with cardiovascular diseases (CVD) had higher UA, but not UCR, levels. Patients with higher UCR values showed worse disease-related outcomes (lung function, symptoms, quality of life, history of exacerbations, BODCAT and BODEx). Also, UCR differentiated patients with different severity of airflow limitation as well as symptoms and exacerbations. The great individual predictive potential of UCR and IL-1β was observed with their odds ratios (OR) being 2.09 and 5.53, respectively. Multiparameter models of UA and UCR that included IL-1β were able to correctly classify 86% and 90% of cases, respectively. We suggest that UA might be a useful biomarker when combined with IL-1β, while UCR might be even more informative and useful in overall COPD assessments.
Highlights
Despite continuous and intensive effort from the side of health care providers, scientists and pharmaceutical industry, numbers regarding chronic obstructive pulmonary disease (COPD) outcomes associated with quality of life, morbidity and mortality are not improving and more than 3 million people die from COPD each year
Uric acid (UA) and UA and its ratio with creatinine (UCR) levels are associated with inflammatory parameters in COPD patients We assessed the lung function parameters and body mass index (BMI) as well as various inflammatory parameters in COPD patients in the stable phase of the disease and in healthy subjects matched with the patients by both age and sex (Table 1)
We found no significant associations between lung function parameters, COPD-relevant scores or multicomponent indices and UA or UCR, while only UA was positively correlated with BMI (r = 0.425, P
Summary
Despite continuous and intensive effort from the side of health care providers, scientists and pharmaceutical industry, numbers regarding chronic obstructive pulmonary disease (COPD) outcomes associated with quality of life, morbidity and mortality are not improving and more than 3 million people die from COPD each year. The pathogenesis of COPD is very complex and heterogeneous, and both oxidative stress and chronic low-grade inflammation are among the mechanisms proposed for COPD development. These disturbances are present not just locally in the respiratory system, and throughout the organism, and systemic inflammation is recognized as one of the possible endotypes of COPD [3,4]
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