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Systemic biomarkers in exacerbations of COPD: the evolving clinical challenge.

Type of publication Peer-reviewed
Publikationsform Review article (peer-reviewed)
Author Koutsokera Angela, Stolz Daiana, Loukides Stelios, Kostikas Konstantinos,
Project Preventing viral exacerbation of chronic obstructive pulmonary disease in upper respiratory tract infection - The PREVENT study
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Review article (peer-reviewed)

Journal Chest
Volume (Issue) 141(2)
Page(s) 396 - 405
Title of proceedings Chest
DOI 10.1378/chest.11-0495


BACKGROUND Exacerbations of COPD (ECOPD) remain a major cause of mortality and morbidity. Despite advances in the understanding of their pathophysiology, their assessment relies primarily on clinical presentation, which can be variable and difficult to predict. A large number of biomarkers already have been assessed in this context, and some appear to be promising. METHODS An online search for articles published until December 2010 was conducted using three terms for ECOPD, five terms for biomarkers, and five terms for the sampling method. Biomarkers were evaluated for their potential role in the establishment and confirmation of the diagnosis of ECOPD, the evaluation of etiology and severity, the prediction of prognosis, and the guidance of treatment decisions. RESULTS Several systemic biomarkers have been measured in the context of ECOPD, and most have been found to increase at ECOPD onset and to subside during the course of exacerbations. Correlations have been reported among these biomarkers, but direct associations with clinical variables have been more difficult to establish. Although there are several limitations yet to be addressed, some of the biomarkers, most notably C-reactive protein for the identification of an ECOPD and procalcitonin for antibiotic guidance, may provide clinically relevant information. CONCLUSIONS So far, no single biomarker has been able to gain wide acceptance, but some provide clinically useful information. The evaluation of such biomarkers in large decision-making studies is expected to become an area of intense investigation in the near future.