SPUTUM NEUTROPHILS AS A BIOMARKER IN PATIENTS WITH CHRONIC OBSTRUCTIVE PULMONARY DISEASE
Malkesh Meena, S. K. Agarwal and Deepak Kumar Shah*
ABSTRACT
Introduction: COPD is a common, preventable and treatable disease with increased disease burden accounting for significant mortality. A hallmark feature of COPD is the increased numbers of pulmonary neutrophils that can secrete a wide range of pro-inflammatory cytokines and chemokines as well as proteases that play role in the development of emphysema. We aimed to find out a simple, accessible and economical biomarker to prevent morbidity & mortality associated with COPD. Induced sputum is a non-invasive method that allows evaluation of neutrophil numbers in the airway lumen. Methods: A longitudinal comparative study involving 50 COPD patients with age, sex, race matched individuals were categorized into treatment group (Group1) and control group (Group2) underwent sputum induction and analysis to look for sputum neutrophil and its relation to COPD exacerbation and management. Response to treatment was measured using spirometry (FEV1, FEV1/FVC). Observation: We found out that 76% of the COPD patients had >70 Sputum Neutrophil count which persisted among 28% of the COPD patients despite treatment with macrolide. Most of the group 1 patients improved with macrolide treatment in addition to usual bronchodilators as shown by improvement in pre and post FEV1(p=0.001); compared to group 2 patients where there was no significant changes in pre and post FEV1(p=0.516). Sputum Neutrophil was significantly associated with improvement in CAT Score (p=0.009) and reduction in exacerbation(p=0.002). Conclusion: The author strongly concludes that sputum neutrophil count could prove to be one of the Significant biomarker to predict and manage the exacerbation of COPD.
Keywords: COPD, FEV1, FEV1/FVC.
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