Blood biomarkers for better personalized management of Chronic Obstructive Pulmonary Disease
Introduction Chronic obstructive pulmonary disease(COPD)is a common clinical disorder which is characterized with complexity and heterogeneority in disease process.In addition,it leads to growing morbidity,mortality,and health-care expense worldwide.Undoubtly,the complexity and heterogeneity of this disease partly takes responsibilities for such limitations and difficulties in COPD management and urgently calls for more personlized assessment and treatment of COPD patients.Of imperative importance to decipher this clinical entity,many biomarkers in blood,sputum and lung tissue have been identified,as current comprehension of COPD pathophysiology deepens and advancing technologies progress.However,blood as the best specimen for detection for its easily obtained and standardized measurements is becoming a most promising markers for longterm management of COPD.The purpose of this article is focused on revealing the effect of typical and emerging blood biomarkers in COPD personalized management.Methods This paper reviews the latest 5-year data on the blood biomarkers for the COPD management in discovring early stage COPD,predicting disease activity and prognosis,diagnosing AECOPD,identifing subtypes of COPD and guiding therapy.Results Blood biomarkers in COPD can be roughly divided into several kinds such as inflammation biomarkers(ie.C-reactive protein(CRP),fibrinogen,serum surfactant protein D,calara cell protein 16,interleukin(IL)-6),eosinophilic biomarkers,oxidative stress biomarkers,cardiac involved biomarkers and angiogenesis factors involved in the pathogenetic aspect of this disease(angiogenin,and vascular endothelial growth factor).Many blood biomarkers have been demonstrated as potential and useful markers in facilitating COPD mangement.To reflect the state of pathophysiology,blood biomarker gives the clues of systemic inflammation which is related to the morbidity and mortality in COPD patients.Thus,CRP,fibrinogen and IL-6 et al.do some help in diagnosis of exacerbation and in prediction of disease activity.While other blood biomarkers like eosinophils can be used to monitoring disease response to ICS treatment and guiding antibiotics therapy.Blood biomarkers in combination with known clinical variables like forced expiratory volume in one second(FEV1)will probably clarify a part of the prognosis and natural history of the disease.In addition,high-throughput platforms of cellular,proteomic,and genetic biomarkers makes personalized biologic characters of COPD revealed.Conclusion Current medicine in COPD requires more methods to identify key pathways to better understanding disease pathogensis,predict disease phenotype,diagnosis and progression and develop more directed therapy,while statistics show that blood biomarkers do some help in these aspects.In the near future,we believed that integrative approachs combining biomarkers with established clinical parameters and high-throughput platforms to discover emerging blood biomarkers will be instrumental in personalized management in COPD.
chronic obstructive pulmonary disease blood biomarker personalized management diagnosis treatmen
TiaoLi XueHeZhong shangDai YanChen
The Second Xiangya Hospital of Central South University
国内会议
2017中华医学会呼吸病学年会暨第十八次全国呼吸病学学术会议
福州
英文
1-1
2017-09-20（万方平台首次上网日期，不代表论文的发表时间）