Serum sRAGE level is a potential biomarker to differentiate patients experiencing acute respiratory events in mild COPD from those with chronic bronchitis (CB). These distinct levels hint at their potential roles in disease pathogenesis and progression from frequent-CB to frequent-GOLD I. These findings were presented at the 2023 ERS International Congress.

Patients with respiratory disease undergoing treatment may develop acute worsening respiratory symptoms (acute respiratory event [ARE]) that could require additional therapy. Frequent episodes of AREs in COPD or CB are associated with poor prognosis. Therefore, assessing ARE risk is crucial for managing COPD and CB. However, it relies on the history of earlier aggravations and related scores that are relatively subjective. Jinying Chen and his team conducted an analytical study to identify blood-based biomarkers to objectively distinguish CB and mild COPD patients with a high risk for ARE. They extracted relevant data from a comprehensive, prospective, longitudinal cohort study (COMPASS) in which they investigated disease progression and patient outcomes of COPD in China.

The researchers enrolled 347 patients in a COMPASS sub-cohort (96 CB, 82 GOLD I, 121 GOLD II, and 48 GOLD III) and assessed four blood-based biomarkers (CC16, HbA1c, IP-10, and sRAGE that are potentially related to a negative prognosis.

The analysis revealed that out of the four biomarkers, only the sRAGE level showed significant changes. It decreased in frequent-COPD compared with infrequent-COPD (n=37 vs 214; P=0.020) but increased in frequent-CB (n=17 vs 79; P=0.058). Furthermore, sRAGE levels were significantly higher in frequent-CB compared with frequent-GOLD I (P=0.018). Receiver operating characteristic curve analysis also indicated that sRAGE levels could distinguish between frequent-COPD and infrequent-COPD (P=0.013; area under the curve [AUC], 0.620) and between frequent-CB and infrequent-CB (P=0.058; AUC, 0.647).

Despite similar symptoms (except airflow limitation in CB), frequent-CB and frequent-GOLD I patients had varied sRAGE levels, suggesting its role in CB deterioration to frequent-COPD.

The authors concluded that sRAGE is a promising blood biomarker, and its serum level in patients with frequent COPD and those with frequent CB varies evidently enabling us to identify them separately. The different sRAGE patterns between COPD and CB imply distinct pathogenic roles. These findings emphasize the need for further research into sRAGE as a diagnostic tool and potential therapeutic target in respiratory diseases.

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