切换至 "中华医学电子期刊资源库"

中华诊断学电子杂志 ›› 2015, Vol. 03 ›› Issue (02) : 133 -137. doi: 10.3877/cma.j.issn.2095-655X.2015.02.013

所属专题: 文献

临床思维

慢性阻塞性肺疾病急性加重期相关生物标志物及其诊断意义
郭凯1, 殷少军2,()   
  1. 1. 200031 上海交通大学医学院附属瑞金医院远洋分院内科
    2. 200233 上海交通大学附属第六人民医院东院呼吸内科
  • 收稿日期:2014-09-23 出版日期:2015-05-26
  • 通信作者: 殷少军
  • 基金资助:
    上海市卫生局科研基金(2010082); 上海市干部保健局科研基金(2011GB24); 上海市医学会老年医学专科分会基金(LN2011006); 上海申康医院发展中心郊区三级医院临床能力建设项目(SHDC12013901)

Progress and diagnostic value of related biomarkers in acute exacerbation of chronic obstructive pulmonary disease

Kai Guo1, Shaojun Yin2,()   

  1. 1. Department of Internal Medicine, Yuanyang Branch of Ruijin Hospital, Shanghai 200031, China
    2. Department of Respiratory Medicine, Shanghai Six Reople′s Hospital, Shanghai 200233, China
  • Received:2014-09-23 Published:2015-05-26
  • Corresponding author: Shaojun Yin
  • About author:
    Corresponding author: Yin Shaojun, Email:
引用本文:

郭凯, 殷少军. 慢性阻塞性肺疾病急性加重期相关生物标志物及其诊断意义[J/OL]. 中华诊断学电子杂志, 2015, 03(02): 133-137.

Kai Guo, Shaojun Yin. Progress and diagnostic value of related biomarkers in acute exacerbation of chronic obstructive pulmonary disease[J/OL]. Chinese Journal of Diagnostics(Electronic Edition), 2015, 03(02): 133-137.

慢性阻塞性肺疾病是临床常见的肺部疾病,其急性加重(AECOPD)是造成老年人死亡的重要原因之一,早诊断、早治疗是及早阻止疾病发展、改善预后的关键。研究发现AECOPD可能与蛋白酶-抗蛋白酶失衡、氧化应激、炎症及细胞损伤等有关,因此对相关的生物标志物进行研究有助于评估病情的严重程度及治疗情况。近10年,肺生物标志物的具体采样方法有了革命性的创新,主要包括非侵入性、半侵入性以及侵入性方法。本文从这几个方面对所获肺组织标本中的生物标志物进行总结,阐述了呼出气、呼出气冷凝液、自然痰、诱导痰、支气管肺泡灌洗液及肺组织标本中存在的相关炎症生物标志物,并试图突出其相互的联系、解释其潜在的临床作用,以期有助于AECOPD更有意义的临床评估,为治疗选择提供更多参考。

Chronic obstructive pulmonary disease(COPD) is a common lung disease in clinic, and its acute exacerbation (AECOPD) is one of the important cause of death in the elderly.Earlier diagnosis and treatment is vital for preventing the development of diseases and improving prognosis.Studies have shown that AECOPD may be related to protease-antiprotease imbalances, oxidative stress, inflammation, and cell damage and so on, so the study of related biomarkers can help assess the severity and the treatment of the illness.Innovative sampling techniques which mainly include non-invasive, semi-invasive and invasive methods have led to the identification of several pulmonary biomarkers in the past decade.Pulmonary biomarkers are sampled in the exhaled air, exhaled breath condensate, spontaneous sputum, induced sputum, bronchoalveolar lavage fluid and lung biopsies.This article try to highlight the reciprocal links and illustrate the clinical effects of these biomarkers, expecting to contribute to the more significant clinical assessment in AECOPD and provide more references for treatment options.

[1]
Cazzola M,MacNee W,Martinez FJ, et al.Outcomes for COPD pharmacological trials:from lung function to biomarkers[J]. Eur Respir J, 2008, 31(2): 416-469.
[2]
Biomarkers Definitions Working Group.Biomarkers and surrogate endpoints:preferred definitions and conceptual framework[J]. Clin Pharmacol Ther, 2001, 69(3): 89-95.
[3]
Shorter JH,Nelson DD,McManus JB, et al.Clinical study of multiple breath biomarkers of asthma and COPD (NO, CO(2), CO and N(2)O) by infrared laser spectroscopy[J]. J Breath Res, 2011, 5(3): 037108.
[4]
Agusti AG,Villaverde JM,Togores B, et al.Serial measurements of exhaled nitric oxide during exacerbations of chronic obstructive pulmonary disease[J]. Eur Respir J, 1999, 14(3): 523-528.
[5]
Al-Ali MK,Howarth PH.Exhaled nitric oxide levels in exacerbations of asthma, chronic obstructive pulmonary disease and pneumonia[J]. Saudi Med J, 2001, 22(3): 249-253.
[6]
Papi A,Bellettato CM,Braccioni F, et al.Infections and airway inflammation in chronic obstructive pulmonary disease severe exacerbations[J]. Am J Respir Crit Care Med, 2006, 173(10): 1114-1121.
[7]
De Laurentiis G,Maniscalco M,Cianciulli F, et al.Exhaled nitric oxide monitoring in COPD using a portable analyzer[J]. Pulm Pharm acol Ther, 2008, 21(4): 689-693.
[8]
Antus B,Barta I,Horvath I, et al.Relationship between exhaled nitric oxide and treatment response in COPD patients with exacerbations[J]. Respirology, 2010, 15(3): 472-477.
[9]
Antus B,Barta I,Kullmann T, et al.Assessment of exhaled breath condensate pH in exacerbations of asthma and chronic obstructive pulmonary disease:a longitudinal study[J]. Am J Respir Crit Care Med, 2010, 182(12): 1492-1497.
[10]
Cosio BG,Iglesias A,Rios A, et al.Low-dose theophylline enhances the anti-inflammatory effects of steroids during exacerbations of COPD[J]. Thorax, 2009, 64(5): 424-429.
[11]
Corhay JL,Henket M,Nguyen D, et a1.Leukotriene B4 contributes to exhaled breath condensate and sputum neutrophil chemotaxis in COPD[J]. Chest, 2009, 136(4): 1047-1054.
[12]
Montnsehi P,Collins JV,Ciabattoni G, et al.Exhaled 8-isoprostane as an in vivo biomarker of lung oxidative stress in patients with COPD and healthy smokers[J]. Am J Respir Crit Care Med, 2000, 162(3 Pt 1): 1175-1177.
[13]
Ko FW,Leung TF,Wong GW, et al.Measurement of tumor necrosis factor-α, leukotriene B4, and interleukin 8 in the exhaled breath condensate in patients with acute exacerbations of chronic obstructive pulmonary disease[J]. Int J Chron Obstruct Pulmon Dis, 2009(4): 79-86.
[14]
Koutsokera A,Kiropoulos TS,Nikoulis DJ, et al.Clinical, functional and biochemical changes during recovery from COPD exacerbations[J]. Respir Med, 2009, 103(6): 919-926.
[15]
Mazur W,Stark H,Sovijarvi A, et al.Comparison of 8-isoprostane and interleukin-8 in induced sputum and exhaled breath condensate from asymptomatic and symptomatic smokers[J]. Respiration, 2009, 78(2): 209-216.
[16]
Carpagnano GE,Resta O,Foschino-Barbaro MP, et al.Exhaled interleukine-6 and 8-isoprostane in chronic obstructive pulmonary disease:effect of carbocysteine lysine salt monohydrate (SCMC-Lys)[J]. Eur J Pharmacol, 2004, 505(1-3): 169-175.
[17]
Antczak A,Ciebiada M,Pietras T, et al.Exhaled eicosanoids and biomarkers of oxidative stress in exacerbation of chronic obstructive pulmonary disease[J]. Arch Med Sci, 2012, 8(2): 277-285.
[18]
Sethi S,Wrona C,Eschberger K, et al.Inflammatory profile of new bacterial strain exacerbations of chronic obstructive pulmonary disease[J]. Am J Respir Crit Care Med, 2008, 177(5): 491-497.
[19]
Parameswaran GI,Sethi S,Murphy TF.Effects of bacterial infection on airway antimicrobial peptides and proteins in COPD[J]. Chest, 2011, 140(3): 611-617.
[20]
Brusse-Keizer MG,Grotenhuis AJ,Kerstjens HA, et al.Relation of sputum colour to bacterial load in acute exacerbations of COPD[J]. Respir Med, 2009, 103(4): 601-606.
[21]
Hurst JR,Perera WR,Wilkinson TM, et al.Systemic and upper and lower airway inflammation at exacerbation of chronic obstructive pulmonary disease[J]. Am J Respir Crit Care Med, 2006, 173(1): 71-78.
[22]
Sethi S,Muscarella K,Evans N, et al.Airway inflammation and etiology of acute exacerbations of chronic bronchitis[J]. Chest, 2000, 118(6): 1557-1565.
[23]
O′Donnell RA,Peebles C,Ward JA, et a1.Relationship between peripheral airway dysfunction, airway obstruction, and neutrophilic inflammation in COPD[J]. Thorax, 2004, 59(10): 837-842.
[24]
Tobin MJ.Chronic obstructive pulmonary disease, pollution, pulmonary vasular disease, transplantation, pleural disease, and lung cancer in AJRCCM 2002[J]. Am J Respir Crit Care Med, 2003, 167(3): 356-370.
[25]
Wilkinson TM,Hurst JR,Perera WR, et al.Effect of interactions between lower airway bacterial and rhinoviral infection in exacerbations of COPD[J]. Chest, 2006, 129(2): 317-324.
[26]
Pant S,Walters EH,Griffiths A, et al.Airway inflammation and anti-protease defences rapidly improve during treatment of an acute exacerbation of COPD[J]. Respirology, 2009, 14(4): 495-503.
[27]
Hodge G,Nairn J,Holmes M, et al.Increased intracellular T helper 1 proinflammatory cytokine production in peripheral blood, bronchoalveolar lavage and intraepithelial T cells of COPD subjects[J]. Clin Exp Immunol, 2007, 150(1): 22-29.
[28]
Miller M,Ramsdell J,Friedman P, et al.Computed tomographic scan-diagnosed chronic obstructive pulmonary disease emphysema:eotaxin-1 is associated with bronchodilator response and extent of emphysema[J]. J Allergy Clin Immunol, 2007, 120(5): 1118-1125.
[29]
Barnes PJ,Chowdhury B,Kharitonov SA, et al.Pulmonary biomarkers in chronic obstructive pulmonary disease[J]. Am J of Respir Crit Care Med, 2006, 174(1): 6-14.
[30]
Snoeck-Stroband JB,Lapperre TS,Gosman MM, et al.Chronic bronchitis sub-phenotype within COPD:inflammation in sputum and biopsies[J]. Eur Respir J, 2008, 31(1): 70-77.
[31]
Qiu Y,Zhu J,Bandi V, et al.Biopsy neutrophilia, neutrophil chemokine and receptor gene expression in severe exacerbations of chronic obstructive pulmonary disease[J]. Am J Respir Crit Care Med, 2003, 168(8): 968-975.
[32]
杨志寅. 现代医学科学发展中的缺憾和思考[J/CD]. 中华诊断学电子杂志, 2013, 1(1): 1-7.
[33]
郭凯,殷少军. 肺炎诊断相关标志物研究进展[J/CD]. 中华诊断学电子杂志, 2014, 2(2): 142-145.
[1] 黄蓉, 梁自毓, 祁文瑾. NLRP3炎症小体在胎膜早破孕妇血清中的表达及其意义[J/OL]. 中华妇幼临床医学杂志(电子版), 2024, 20(05): 540-548.
[2] 王振宇, 张洪美, 荆琳, 何名江, 闫奇. 膝骨关节炎相关炎症因子与血浆代谢物间的因果关系及中介效应[J/OL]. 中华损伤与修复杂志(电子版), 2024, 19(06): 467-473.
[3] 张洁, 罗小霞, 余鸿. 系统性免疫炎症指数对急性胰腺炎患者并发器官功能损伤的预测价值[J/OL]. 中华普外科手术学杂志(电子版), 2025, 19(01): 68-71.
[4] 唐梅, 周丽, 牛岑月, 周小童, 王倩. ICG荧光导航的腹腔镜肝切除术临床意义[J/OL]. 中华普外科手术学杂志(电子版), 2024, 18(06): 655-658.
[5] 付成旺, 杨大刚, 王榕, 李福堂. 营养与炎症指标在可切除胰腺癌中的研究进展[J/OL]. 中华普外科手术学杂志(电子版), 2024, 18(06): 704-708.
[6] 杜贵伟, 陆勇, 成博, 贺薏, 梁爽. 钬激光碎石术术后联合坦索罗辛治疗对输尿管结石患者的影响分析[J/OL]. 中华腔镜泌尿外科杂志(电子版), 2024, 18(05): 491-496.
[7] 高娟, 徐建庆, 闫芳, 丁盛华, 刘霞. Rutkow、TAPP、TEP 手术治疗单侧腹股沟疝患者的临床疗效及对血清炎症因子水平的影响[J/OL]. 中华疝和腹壁外科杂志(电子版), 2024, 18(06): 675-680.
[8] 邢嘉翌, 龚佳晟, 祝佳佳, 陆群. 肺癌化疗患者继发肺部感染的病原菌耐药性及炎症因子变化分析[J/OL]. 中华肺部疾病杂志(电子版), 2024, 17(05): 714-718.
[9] 李智, 冯芸. NF-κB 与MAPK 信号通路及其潜在治疗靶点在急性呼吸窘迫综合征中的研究进展[J/OL]. 中华肺部疾病杂志(电子版), 2024, 17(05): 840-843.
[10] 孙璐, 蒋亚玲, 陈凌君. 布托啡诺对脑缺血再灌注损伤大鼠神经炎症和JAK2/STAT3信号通路的影响[J/OL]. 中华细胞与干细胞杂志(电子版), 2024, 14(06): 344-350.
[11] 杜霞, 马梦青, 曹长春. 造影剂诱导的急性肾损伤的发病机制及干预靶点研究进展[J/OL]. 中华肾病研究电子杂志, 2024, 13(05): 279-282.
[12] 陈利, 杨长青, 朱风尚. 重视炎症性肠病和代谢相关脂肪性肝病间的串话机制研究[J/OL]. 中华消化病与影像杂志(电子版), 2024, 14(05): 385-389.
[13] 王湛, 李文坤, 杨奕, 徐芳, 周敏思, 苏珈仪, 王亚丹, 吴静. 炎症指标在早发性结直肠肿瘤中的应用[J/OL]. 中华临床医师杂志(电子版), 2024, 18(09): 802-810.
[14] 牟磊, 徐东成, 韩鑫, 徐长江, 韩坤锜, 薛叶潇, 牟媛, 秦文玲, 刘相静, 陈哲, 高楠. 五虫通络胶囊防治椎动脉开口支架术后再狭窄发生的效果[J/OL]. 中华脑血管病杂志(电子版), 2024, 18(05): 467-472.
[15] 欧春影, 李晓宾, 郭靖, 朱亮, 许可, 王梦, 安晓雷. 丁苯酞对血管性认知障碍大鼠炎症因子的影响及对认知障碍的改善作用[J/OL]. 中华脑血管病杂志(电子版), 2024, 18(05): 483-487.
阅读次数
全文


摘要


AI


AI小编
你好!我是《中华医学电子期刊资源库》AI小编,有什么可以帮您的吗?