Combining biomarkers of clot resolution and alveolar basement membrane destruction predicts mortality in the ECLIPSE COPD cohort - 12/11/20
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Abstract |
Background |
Chronic obstructive pulmonary disease (COPD) is characterized by abnormal epithelial repair resulting in a hypercoagulable state with intra-alveolar accumulation of fibrin and alveolar basement membrane destruction. This study aimed to investigate if the combination of two serological biomarkers evaluating these pathological processes could improve the prediction of mortality risk compared to single biomarkers.
Methods |
Matrix metalloproteinase-mediated degradation of the type IV collagen α3 chain (C4Ma3), located in the alveolar basement membrane, and plasmin-mediated degradation of crosslinked fibrin (X-FIB), an end-product of fibrinogen, were assessed serologically in a subset of the ECLIPSE cohort (n = 982). Biomarker data were dichotomized into high versus low at the median. Cox regression and Kaplan-Meier curves were used to analyze the predictive value of having one or two high biomarkers for all-cause mortality over two years.
Results |
COPD participants with high levels of two biomarkers were at significantly higher risk of all-cause mortality with a hazard ratio of 7.66 (95% CI 1.75–33.48; p = 0.007) while participants with one high biomarker were not at significantly higher risk (HR 3.79 [95% CI 0.85–16.94]; p = 0.08).
Conclusions |
A combination of serological biomarkers of alveolar basement membrane destruction and clot resolution was predictive of all-cause mortality in COPD. The combination of two different pathological aspects may strengthen prognostic accuracy and could be used in conjunction with clinical assessment to guide treatment decisions.
Le texte complet de cet article est disponible en PDF.Highlights |
• | COPD is characterized by abnormal wound healing and alveolar tissue remodeling. |
• | The serological biomarkers X-FIB and C4Ma3 assess two different aspects of pathology. |
• | Patients with high levels of both X-FIB and C4Ma3 were at higher risk of mortality. |
• | The combination of two pathological aspects of COPD improved prognostic accuracy. |
Keywords : COPD, Biomarkers, Basement membrane, Clot resolution, Fibrinogen, Mortality
Plan
Vol 173
Article 106185- novembre 2020 Retour au numéroBienvenue sur EM-consulte, la référence des professionnels de santé.
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