Association of Fibrinogen and Neutrophil Levels with Incidence and Severity of Chronic Obstructive Pulmonary Disease

Authors

  • Muhammad Ilyas Division of Pulmonary Medicine, Department of Internal Medicine, Medicine Faculty, Hasanuddin University

Keywords:

COPD, neutrophil, fibrinogen, COPD severity

Abstract

The major characteristic of COPD is systemic inflammation. This inflammatory process stimulates hematopoietic system, especially bone marrow, to release leukocytes and stimulates the liver to produce acute-phase proteins such as fibrinogen. Fibrinogen levels tend to increase with severe airflow obstruction. High neutrophil levels are associated with a decrease in FEV1 even beyond exacerbations. In this study, we evaluated the relationship between fibrinogen and neutrophil levels with severity of COPD. The objective of this study was to analyze the correlation between fibrinogen and neutrophil levels with the incidence and severity of COPD. Design of this study was observational with a cross-sectional approach to population of COPD patients from May to July 2017 and healthy people as control. Consecutive sampling did a sampling of COPD patients. We evaluated clinical, CAT score, history of exacerbations, number of cigarettes consumed, fibrinogen, and neutrophil levels. From 35 COPD subjects and 21 healthy controls, we found that fibrinogen and neutrophils levels increased in COPD subjects compared to control (p <0.001), there was no significant correlation of fibrinogen and neutrophil levels with smoking status on COPD subjects (p> 0.05), Fibrinogen levels was significantly higher in exacerbation COPD than stable (p <0.001) but not with neutrophil, there was no significant correlation between smoking status and amount of cigarettes with  COPD severity(p> 0,05), there was significant correlation between fibrinogen levels with COPD severity (p <0.001) but not with neutrophils. Conclusion of this study is there was a correlation between fibrinogen with COPD incidence and severity.  However, neutrophils levels associated with COPD incidence.

References

Alvar Agusti, Marc Decramer, Rongchang Chen, et al. Global Initiative for Chronic Obstructive Lung Disease: Pocket Guide to COPD Diagnosis, Management, and Prevention A Guide for Health Care Professionals. In: Hadfield R, ed. UK: Global Initiative for Chronic Obstructive Lung Disease, Inc; 2017:42.

Maranatha D. Penyakit Paru Obstruktif Kronik (PPOK). In: Wibisono MJ, ed. Buku Ajar Ilmu Penyakit Paru. 5 ed. Surabaya: Departemen Ilmu Penyakit Dalam; 2013:41-57.

Soeroto AY. Penyakit Paru Obstruktif Kronis. In: Zulkarnain Dahlan ea, ed. Kompendium Tatalaksana Respirologi dan Respirasi Kritis 2ed. Bandung: PERPARI (Perhimpunan Respirologi Indonesia); 2013:31-52.

Mona Fattouh, Alkady O. In?ammatory biomarkers in chronic obstructive pulmonary disease. Egyptian Journal of Chest Diseases and Tuberculosis 2014:799-804.

Jennewein C, Tran N, Paulus P, et al. Novel aspects of fibrin(ogen) fragments during inflammation. Mol Med 2011;17:568-73.

Kolaczkowska E, Kubes P. Neutrophil recruitment and function in health and inflammation. Nat Rev Immunol 2013;13:159-75.

Yunita Arliny, Faisal Yunus, Wiwien H Wiyono, et al. Kadar Fibrinogen dan Faktor-faktor Resiko Sindrom Metabolik pada Pasien Penyakit Paru Obstruktif Kronik (PPOK) Stabil. J Indon Med Assoc 2011;61.

Mannino DM, Valvi D, Mullerova H, et al. Fibrinogen, COPD and mortality in a nationally representative U.S. cohort. Copd 2012;9:359-66.

Agusti A, Edwards LD, Rennard SI, et al. Persistent systemic inflammation is associated with poor clinical outcomes in COPD: a novel phenotype. PLoS One 2012;7:e37483.

Dixon LC, Ward DJ, Smith J, et al. New and emerging technologies for the diagnosis and monitoring of chronic obstructive pulmonary disease: A horizon scanning review. Chron Respir Dis 2016.

Pavord ID, Jones PW, Burgel PR, et al. Exacerbations of COPD. Int J Chron Obstruct Pulmon Dis 2016;11 Spec Iss:21-30.

Tantucci C, Modina D. Lung function decline in COPD. Int J Chron Obstruct Pulmon Dis 2012;7:95-9.

Alexandra Comes, Edith Simona Iano?i, Jimborean G. Inflammatory Biomarkers in Chronic Obstructive Pulmonary Disease. University of Medicine and Pharmacy, T

Hurst JR, Vestbo J, Anzueto A, et al. Susceptibility to exacerbation in chronic obstructive pulmonary disease. N Engl J Med 2010;363:1128-38.

do Nascimento ES, Sampaio LM, Peixoto-Souza FS, et al. Home-based pulmonary rehabilitation improves clinical features and systemic inflammation in chronic obstructive pulmonary disease patients. Int J Chron Obstruct Pulmon Dis 2015;10:645-53.

Faner R, Tal-Singer R, Riley JH, et al. Lessons from ECLIPSE: a review of COPD biomarkers. Thorax 2014;69:666-72.

Casaburi R, Celli B, Crapo J, et al. The COPD Biomarker Qualification Consortium (CBQC). Copd 2013;10:367-77.

Laurentia K. Mihardja, Delima, Farida Soetiarto, et al. Penyakit Tidak Menular. Riset Kesehatan Dasar: RISKESDAS 2013. Jakarta: Badan Penelitian dan Pengembangan Kesehatan Kementrian Kesehatan RI; 2013:85.

Vestbo J, Hurd SS, Agusti AG, et al. Global strategy for the diagnosis, management, and prevention of chronic obstructive pulmonary disease: GOLD executive summary. Am J Respir Crit Care Med 2013;187:347-65.

Kaul S. Pathophysiology. In: Laura Blackler RN ea, ed. Managing Chronic Obstructive Pulmonary Disease. England: John Wiley & Sons Ltd; 2007:292.

Liam Heaney, Masih I. Inflammation in COPD and New Drug Strategies In: Khatami M, ed. Inflammation, Chronic Diseases and Cancer

Bambang Sigit Riyanto, Heni Retno Wulan, Hisyam B. Obstruksi Saluran Pernapasan Akut. In: Setiati S, ed. Buku Ajar Ilmu Penyakit Dalam. 6 ed. Jakarta: InternaPublishing Pusat Penerbitan Ilmu Penyakit Dalam; 2014:1602.

Wandersee K. Pathophysiology of COPD. In: Han MK, ed. Pulmonology. New Jersey: Projects In Knowledge, Inc; 2017:2142.

Valvi D, Mannino DM, Mullerova H, et al. Fibrinogen, chronic obstructive pulmonary disease (COPD) and outcomes in two United States cohorts. Int J Chron Obstruct Pulmon Dis 2012;7:173-82.

Jiang R, Burke GL, Enright PL, et al. Inflammatory markers and longitudinal lung function decline in the elderly. Am J Epidemiol 2008;168:602-10.

Garcia-Rio F, Miravitlles M, Soriano JB, et al. Systemic inflammation in chronic obstructive pulmonary disease: a population-based study. Respir Res 2010;11:63.

Peinado VI, Pizarro S, Barbera JA. Pulmonary vascular involvement in COPD. Chest 2008;134:808-14.

Espinosa de los Monteros MJ, Pena C, Soto Hurtado EJ, et al. Variability of respiratory symptoms in severe COPD. Arch Bronconeumol 2012;48:3-7.

Kessler R, Partridge MR, Miravitlles M, et al. Symptom variability in patients with severe COPD: a pan-European cross-sectional study. Eur Respir J 2011;37:264-72.

Kim S, Nadel JA. Fibrinogen binding to ICAM-1 promotes EGFR-dependent mucin production in human airway epithelial cells. Am J Physiol Lung Cell Mol Physiol 2009;297:L174-83.

Su B, Liu T, Fan H, et al. Inflammatory Markers and the Risk of Chronic Obstructive Pulmonary Disease: A Systematic Review and Meta-Analysis. PLoS One 2016;11:e0150586.

Barbu C, Iordache M, Man MG. Inflammation in COPD: pathogenesis, local and systemic effects. Rom J Morphol Embryol 2011;52:21-7.

Alexandra Comes, Edith Simona Iano?i, Jimborean G. Inflammatory Biomarkers in Chronic Obstructive Pulmonary Disease. Journal of Interdisciplinary Medicine 2016:12-7.

Duvoix A, Dickens J, Haq I, et al. Blood fibrinogen as a biomarker of chronic obstructive pulmonary disease. Thorax 2013;68:670-6.

Zhang Y, Li S, Wang G, et al. Changes of HMGB1 and sRAGE during the recovery of COPD exacerbation. J Thorac Dis 2014;6:734-41.

Erdal ?n, Mutlu Kulu

Nicola J Sinden, Stockley RA. Systemic in?ammation and comorbidity in COPD: a result of

Lomas DA, Lipson DA, Miller BE, et al. An oral inhibitor of p38 MAP kinase reduces plasma fibrinogen in patients with chronic obstructive pulmonary disease. J Clin Pharmacol 2012;52:416-24.

Sara Ongay, Frank Klont, Peter Horvatovich, et al. Prioritization of COPD protein biomarkers, based on a systematic study of the literature The Netherlands: Advances in Precision Medicine; 2015:12-24.

Thomsen M, Ingebrigtsen TS, Marott JL, et al. Inflammatory biomarkers and exacerbations in chronic obstructive pulmonary disease. Jama 2013;309:2353-61.

Lazovic B. Correlation of CRP and serum level of fibrinogen with severity of disease in chronic obstructive pulmonary disease patients. Med Arch 2012;66:159-60.

Agusti A, Gea J, Faner R. Biomarkers, the control panel and personalized COPD medicine. Respirology 2016;21:24-33.

Shaw JG, Vaughan A, Dent AG, et al. Biomarkers of progression of chronic obstructive pulmonary disease (COPD). J Thorac Dis 2014;6:1532-47.

Tatsiana Beiko, Strange C. Chronic Obstructive Pulmonary Disease Biomarkers. Eurasian J Pulmonol 2016:3-10.

Mannino DM, Tal-Singer R, Lomas DA, et al. Plasma Fibrinogen as a Biomarker for Mortality and Hospitalized Exacerbations in People with COPD. Chronic Obstr Pulm Dis 2015;2:23-34.

Sadik CD, Kim ND, Luster AD. Neutrophils cascading their way to inflammation. Trends Immunol 2011;32:452-60.

Alley TL. Periphery: Innate Immune Response. In: Kim Moscatello, ed. USMLE Step 1 Lecture Notes 2016 Immunology and Microbiology. New York: Kaplan Inc; 2016:38.

Singh D, Edwards L, Tal-Singer R, et al. Sputum neutrophils as a biomarker in COPD: findings from the ECLIPSE study. Respir Res 2010;11:77.

Baines KJ, Simpson JL, Gibson PG. Innate immune responses are increased in chronic obstructive pulmonary disease. PLoS One 2011;6:e18426.

Austin V, Crack PJ, Bozinovski S, et al. COPD and stroke: are systemic inflammation and oxidative stress the missing links? Clin Sci (Lond) 2016;130:1039-50.

Quint JK, Wedzicha JA. The neutrophil in chronic obstructive pulmonary disease. J Allergy Clin Immunol 2007;119:1065-71.

Kawayama T, Kinoshita T, Matsunaga K, et al. Responsiveness of blood and sputum inflammatory cells in Japanese COPD patients, non-COPD smoking controls, and non-COPD nonsmoking controls. Int J Chron Obstruct Pulmon Dis 2016;11:295-303.

Mirella Pro?ta, Angelo Sala, Anna Bonanno, et al. Chronic obstructive pulmonary disease and neutrophil in?ltration: role of cigarette smoke and cyclooxygenase products. Am J Physiol Lung Cell Mol Physiol 2010:L261

Fan VS, Gharib SA, Martin TR, et al. COPD disease severity and innate immune response to pathogen-associated molecular patterns. Int J Chron Obstruct Pulmon Dis 2016;11:467-77.

Lee H, Um SJ, Kim YS, et al. Association of the Neutrophil-to-Lymphocyte Ratio with Lung Function and Exacerbations in Patients with Chronic Obstructive Pulmonary Disease. PLoS One 2016;11:e0156511.

Larsson S, Nordenson A, Glader P, et al. A gender difference in circulating neutrophils in malnourished patients with COPD. Int J Chron Obstruct Pulmon Dis 2011;6:83-8.

Kersul AL, Iglesias A, Rios A, et al. Molecular mechanisms of inflammation during exacerbations of chronic obstructive pulmonary disease. Arch Bronconeumol 2011;47:176-83.

Vogelmeier C, Aquino TO, O'Brien CD, et al. A randomised, placebo-controlled, dose-finding study of AZD9668, an oral inhibitor of neutrophil elastase, in patients with chronic obstructive pulmonary disease treated with tiotropium. Copd 2012;9:111-20.

Anzueto A. Impact of exacerbations on COPD. Eur Respir Rev 2010;19:113-8.

Agusti A, Calverley PM, Celli B, et al. Characterisation of COPD heterogeneity in the ECLIPSE cohort. Respir Res 2010;11:122.

Kurtipek E, Bekci TT, Kesli R, et al. The role of neutrophil-lymphocyte ratio and platelet-lymphocyte ratio in exacerbation of chronic obstructive pulmonary disease. J Pak Med Assoc 2015;65:1283-7.

Milara J, Juan G, Peiro T, et al. Neutrophil activation in severe, early-onset COPD patients versus healthy non-smoker subjects in vitro: effects of antioxidant therapy. Respiration 2012;83:147-58.

Miller J, Edwards LD, Agusti A, et al. Comorbidity, systemic inflammation and outcomes in the ECLIPSE cohort. Respir Med 2013;107:1376-84.

Andelid K, Andersson A, Yoshihara S, et al. Systemic signs of neutrophil mobilization during clinically stable periods and during exacerbations in smokers with obstructive pulmonary disease. Int J Chron Obstruct Pulmon Dis 2015;10:1253-63.

Xiong W, Xu M, Zhao Y, et al. Can we predict the prognosis of COPD with a routine blood test? Int J Chron Obstruct Pulmon Dis 2017;12:615-25.

Cockayne DA, Cheng DT, Waschki B, et al. Systemic biomarkers of neutrophilic inflammation, tissue injury and repair in COPD patients with differing levels of disease severity. PLoS One 2012;7:e38629.

He Z, Chen Y, Chen P, et al. Local inflammation occurs before systemic inflammation in patients with COPD. Respirology 2010;15:478-84.

Cermakian N, Lange T, Golombek D, et al. Crosstalk between the circadian clock circuitry and the immune system. Chronobiol Int 2013;30:870-88.

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Published

2019-08-14

How to Cite

Ilyas, M. . (2019). Association of Fibrinogen and Neutrophil Levels with Incidence and Severity of Chronic Obstructive Pulmonary Disease. International Journal of Sciences: Basic and Applied Research (IJSBAR), 48(1), 143–159. Retrieved from https://gssrr.org/index.php/JournalOfBasicAndApplied/article/view/10235

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