Turkiye Klinikleri Journal of Medical Sciences

.: ORIGINAL RESEARCH
Comparison of Biomarkers in Blood and Urine According to Phenotypes in Chronic Obstructive Pulmonary Disease: Cross-Sectional Research
Kronik Obstrüktif Akciğer Hastalığında Fenotiplere Göre Kanda ve İdrarda Biyobelirteçlerin Karşılaştırılması: Kesitsel Araştırma
Oylum HÜNERELa, Pınar MUTLUa, Nihal Arzu MİRİCİa, Dilek Ülker ÇAKIRb, Hakan TÜRKÖNb, Abdulhakim Hasan GÜLb
aDepartment of Chest Diseases, Çanakkale Onsekiz Mart University Faculty of Medicine, Çanakkale, Türkiye
bDepartment of Medical Biochemistry, Çanakkale Onsekiz Mart University Faculty of Medicine, Çanakkale, Türkiye
Turkiye Klinikleri J Med Sci. 2022;42(3):183-90
doi: 10.5336/medsci.2021-86396
Article Language: EN
Full Text
ABSTRACT
 Objective: Chronic obstructive pulmonary disease (COPD) is one of the leading causes of morbidity and mortality worldwide. Biomarkers have been recognized as an important tool in assessing COPD patients. In this study, we aimed to investigate the possible relationship between certain biomarkers and different COPD phenotypes. Material and Methods: Between January 1, 2017-December 31, 2017, a total of 85 patients who were admitted to the Çanakkale Onsekiz Mart University Faculty of Medicine Hospital Chest Diseases Outpatient Clinic with a diagnosis of COPD according to the Global Initiative for Chronic Obstructive Lung Disease 2017 Guidelines were included in this study. All patients filled in the COPD Assessment Test and modified Medical Research Council questionnaires. Patients were divided into 4 phenotypes: emphysema, chronic bronchitis, frequent exacerbation, and asthma COPD overlap syndrome (ACOS). Levels of C-reactive protein (CRP), desmosine, fibronectin, eotaxin, and interleukin (IL)-2 were measured and compared between the phenotypes. Results: The mean age was 64.56 years and 92.9% of the study population were males. Of 85 patients, 43 had emphysema, 13 had frequent exacerbation, 15 had chronic bronchitis, and 14 had ACOS phenotype. Blood fibronectin, eotaxin, and urine desmosine levels were significantly lower in patients with ACOS phenotype compared to the other phenotypes. In patients with the frequent exacerbation phenotype, the CRP level was significantly higher than that of the other three phenotypes. The IL-2 levels were similar in all phenotypes. Conclusion: Our study results suggest that these biomarkers may be useful in the differential diagnosis of COPD phenotypes.

Keywords: Pulmonary disease; chronic obstructive; phenotype; biomarkers
ÖZET
 Amaç: Kronik obstrüktif akciğer hastalığı (KOAH), ülkemiz ve tüm dünya ülkelerinde önemli mortalite ve morbidite nedeni olan bir hastalıktır. Biyomarker ölçümleri KOAH'ın değerlendirilmesinde giderek daha önemli bir hâl almaktadır. Çalışmamızın amacı, biyomarker düzeylerinin KOAH fenotipleri arasında anlamlı farklılık gösterip göstermediğini araştırmaktır. Gereç ve Yöntemler: Çalışmamıza, 1 Ocak 2017-31 Aralık 2017 tarihleri arasında, Çanakkale Onsekiz Mart Üniversitesi Tıp Fakültesi Hastanesi Göğüs Hastalıkları Polikliniğine başvuran, KOAH tanılı veya 'Global Initiative for Chronic Obstructive Lung Disease' 2017 kılavuzuna göre KOAH tanısı konulan 85 hasta alınmıştır. Hastalar, KOAH değerlendirme Testi ve 'modifiye Medical Research Council' anketleri doldurmuştur. Amfizem, sık alevlenenler, kronik bronşit ve astım-KOAH ortak sendromu (AKOS) olmak üzere 4 fenotipe ayrılmıştır. Hastalardan venöz kan örneği ve idrar örneği alınmıştır. C-reaktif protein (CRP), desmozin, eotaksin, fibronektin ve interlökin-2 (IL-2) biyobelirteç düzeyleri belirlenmiştir. Bulgular: Araştırmaya katılan hastaların yaş ortalaması 64,56'dır. Örneklemin %92,9'u erkektir. Toplam 85 hastanın 43'ü amfizem, 13'ü sık alevlenen, 15'i kronik bronşit, 14'ü AKOS fenotipindedir. Kan fibronektin, eotaksin ve idrar desmozin düzeyi AKOS fenotipindeki hastalarda diğer fenotiplerin tümünden anlamlı derecede düşüktür. Sık alevlenen fenotipindeki hastalarda CRP düzeyi diğer fenotiplerin tümünden anlamlı derecede yüksektir. Fenotipler arasında, IL-2 düzeyi ortalamaları açısından fark yoktur. Sonuç: Çalışmamız sonucunda, KOAH fenotipleri arasında biyobelirteç düzeyleri açısından anlamlı farklılıklar bulunmuş olup; çalışmamızın, bu konuda yapılacak daha kapsamlı araştırmalara ışık tutacağı kanaatindeyiz.

Anahtar Kelimeler: Akciğer hastalığı; kronik obstrüktif; fenotip; biyobelirteçler
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