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Pancreatic stone protein predicts positive sputum bacteriology in exacerbations of COPD.

Type of publication Peer-reviewed
Publikationsform Original article (peer-reviewed)
Author Scherr Andreas, Graf Rolf, Bain Martha, Christ-Crain Mirjam, Müller Beat, Tamm Michael, Stolz Daiana,
Project Preventing viral exacerbation of chronic obstructive pulmonary disease in upper respiratory tract infection - The PREVENT study
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Original article (peer-reviewed)

Journal Chest
Volume (Issue) 143(2)
Page(s) 379 - 87
Title of proceedings Chest
DOI 10.1378/chest.12-0730

Abstract

BACKGROUND Pancreatic stone protein/regenerating protein (PSP/reg) serum levels are supposed to be increased in bacterial inflammation. PSP/reg levels also might be useful, therefore, as a predictor of bacterial infection in COPD. METHODS Two hundred consecutive patients presenting to the ED due to acute exacerbation of COPD were prospectively assessed. Patients were evaluated based on clinical, laboratory, and lung functional parameters at admission (exacerbation) and after short-term follow-up (14-21 days). PSP/reg serum values were measured by a newly developed enzyme-linked immunosorbent assay. RESULTS PSP/reg levels were elevated in subjects with COPD exacerbation (23.8 ng/mL; 95% CI, 17.1-32.7) when compared with those with stable disease (19.1 ng/mL; 95% CI, 14.1-30.4; P 5 .03) and healthy control subjects (14.0 ng/mL; 95% CI , 12.0-19.0; P , .01). Higher PSP/reg values were observed in exacerbations with positive sputum bacteriology compared with those with negative sputum bacteriology (26.1 ng/mL [95% CI, 19.2-38.1] vs 20.8 ng/mL [95% CI , 15.6-27.2]; P , .01). Multivariate regression analysis revealed PSP/reg level as an independent predictor of positive sputum bacteriology. A combination of a PSP/reg cutoff value of . 33.9 ng/mL and presence of discolored sputum had a specificity of 97% to identify patients with pathogenic bacteria on sputum culture. In contrast, PSP/reg levels , 18.4 ng/mL and nonpurulent sputum ruled out positive bacterial sputum culture (sensitivity, 92%). In survival analysis, high PSP/reg levels at hospital admission were associated with increased 2-year mortality. CONCLUSIONS Serum PSP/reg level might represent a promising new biomarker to identify bacterial etiology of COPD exacerbation.
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