The correlation of pentraxin 3 value with CRP as an inflammatory indicator in the acute attack and stable period in copd patients

Chronic Obstructive Pulmonary Disease (COPD) is a disease characterized by frequent exacerbations and chronic inflammation caused by airway obstruction and parenchymal destruction. Exacerbations that may occur in the natural course of the disease; It accelerates the decrease in lung functions and adversely affects the quality of life and prognosis. During an exacerbation, there is an increase in the number of acute phase reactant proteins and inflammatory cells in the circulation. Some inflammatory markers, such as C-reactive protein (CRP), are associated with COPD, suggesting the negative consequences of high CRP levels in COPD and the development of cardiovascular complications such as atherosclerosis. It has also been shown to predict the prognosis of COPD and the diagnosis of acute exacerbations. The aim of this study was to determine the PTX-3 levels, CRP (C-reactive protein), WBC (leukocyte count), NLR (neutrophil/lymphocyte ratio) and TLR (platelet/lymphocyte ratio) levels measured at the time of admission to the hospital in exacerbation and stable periods of COPD. To investigate the correlation of these levels with COPD exacerbations and the use of these levels as a prognostic biomarker for early treatment planning, development of complications, need for intensive care and reduction of poor outcomes such as mortality. In addition, it was aimed to determine the relationship between plasma PTX-3 and disease symptoms, severity, presence of pneumonia, dyspnea and symptom scales, and airway obstruction parameters and that it could be a potential biomarker for bacteria-related exacerbation in patients with COPD. 35 patients admitted to Tekirdağ Namık Kemal University Research and Application Hospital between April 2022 and October 2022 and hospitalized with COPD exacerbation, 35 patients to determine their levels in stable COPD patients and 19 healthy individuals were included as a control group. The results of CRP and WBC tests were recorded. NLR and TLR were calculated. Cases with symptoms of increased dyspnea, cough, increased sputum amount or sputum purulence were included in the COPD exacerbation group. Symptoms, dyspnea scales, pulmonary function test parameters, GOLD stages, and long-term oxygen use status of COPD patients were recorded. PTX-3 was studied from peripheral blood by ELISA method. Among the groups, PTX-3 values were 2,7 [1,7-11,5] in the COPD attack group, 2,6 [0,2-6,5] in the COPD stable group, and 2,4 [1,7-3,2] in the healthy controls, respectively, and were not found significant. There was a significant difference between COPD and control groups in terms of PTX-3 values, and PTX-3 values were found to be higher in the COPD group. The median value of PTX-3 was 2.6 [0.2-11.5] in the COPD group and 2.4 [1.7-3.2] in the control group. In correlation analyzes, 20 individuals in the COPD attack group had cough complaints and were positively correlated with PTX-3 levels [3.5 (1.9-8.8), p=0.040]. While there was no significant correlation between inflammation markers CRP, WBC, NLR and TLO values and PTX-3, a positive correlation was found between CAT and mMRC scores and PTX-3 (p=0.002, p=0.007). In addition, PTX-3 values of patients with a CAT score of 20 and above were found to be significantly higher than those with a CAT score of less than 20. In the studies based on COPD attack status, it was determined that long-term oxygen use, cough symptom and CAT scores were important parameters that increased the risk of COPD attack (24,488, 6.513 and 2,500 times increased the risk of COPD attack, respectively, p<0.05). This is a study showing that PTX-3 values in serum are not different between COPD acute exacerbation and stable patients. However, it was observed that patients with COPD had higher PTX-3 levels than the healthy control group. This suggests that COPD is also characterized by low-grade systemic inflammation in stable patients, and shows that PTX-3 may be an important marker of inflammation in COPD patients. This suggests that abnormal inflammation occurring in patients with COPD is not only limited to the lungs, but also causes systemic and chronic inflammation, and this situation can be observed in patients at any time. More research is needed for biomarkers that can explain and identify the mechanisms that cause systemic inflammation. Keywords: Pentraxin-3, PTX-3, COPD, CRP, exacerbation