Abstract
Background
Asthma and chronic obstructive pulmonary disease (COPD) are characterised by airway and systemic inflammation, but little is known about differences and similarities in inflammatory markers in patients with obstructive airways disease.
Methods
In 210 adult patients presenting to their general practitioners with symptoms suggestive of obstructive airways disease, lung function, fractional exhaled nitric oxide (FENO), blood eosinophils, and serum levels of high-sensitivity C-reactive protein (hs-CRP) and IgE were measured.
Results
hs-CRP levels were increased in COPD patients (p=0.009), whereas FENO, IgE, and eosinophils were increased in patients with asthma (p=0.009, p=0.041, and p=0.009, respectively). In the ROC analysis, hs-CRP had the largest area under the curve (AUC=0.651; 95% confidence interval (CI) 0.552 to 0.749), with a specifity of 83% and a sensitivity of 42% for the diagnosis of COPD. FENO was the most accurate marker in the diagnosis of asthma (AUC=0.618; 95% CI 0.529 to 0.706). Serum hs-CRP levels correlated with the number of smoking pack-years (r=0.218, p=0.001) and inversely with lung function parameters.
Conclusions
Levels of serum hs-CRP, IgE, blood eosinophils, and FENO identify distinct aspects of local and systemic inflammation in patients with obstructive airways disease. This might help to differentiate between asthma and COPD in primary care patients when spirometry is not available.
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All authors contributed to the realisation of this study and the preparation of the manuscript. In detail, LT analysed the data and wrote the manuscript. AS designed the study, helped analysing the data and writing the manuscript. LG was assistant investigator and helped gaining the data. FM interpreted the lung function testing and helped with writing. JS supported implementing the study.
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The authors declare that they have no conflicts of interest in relation to this article.
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Tilemann, L., Gindner, L., Meyer, F. et al. Differences in local and systemic inflammatory markers in patients with obstructive airways disease. Prim Care Respir J 20, 407–414 (2011). https://doi.org/10.4104/pcrj.2011.00069
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DOI: https://doi.org/10.4104/pcrj.2011.00069