Diagnostic value of systemic inflammation and endothelial dysfunction markers in the formation of chronic obstructive pulmonary disease clinical phenotypes


DOI: https://dx.doi.org/10.18565/therapy.2024.7.64-72

Tayutina T.V., Shlyk S.V.

Rostov State Medical University of the Ministry of Healthcare of Russia, Rostov-on-Don
Abstract. Chronic systemic inflammation (SI) in chronic obstructive pulmonary disease (COPD) is accompanied by reactivity of endothelial cells and connective tissue elements. An important aspect of practical medicine is the correlation of SI and endothelial dysfunction (ED) biomarkers with phenotype of the disease.
The aim: to evaluate the diagnostic value of SI and ED markers in the formation of COPD phenotypes.
Material and methods. 78 COPD patients (73% male and 27% female) were examined. The median age of the participants was 61 (95% confidence interval: 58.9–62.4) years. Classification criterion was the phenotype of the disease: group 1 – 40 patients having COPD with a bronchitis phenotype, group 2 – 38 patients with an emphysematous phenotype, the control group – 18 practically healthy individuals. To assess the severity of SI and ED, the level of fibrinogen, C-reactive protein, tumor necrosis factor-alpha (TNF-α), soluble form of intercellular adhesion molecule-1 (sICAM-1) in the blood serum, the concentration of human platelet-derived growth factor AA in saliva, vascular endothelial adhesion molecule type 1 in the blood serum, Willebrand factor related antigen were determined.
Results. The development of COPD is characterized by SI, ED, and hemostatic stress regardless of the disease phenotype. The threshold value of the TNF-α level for the formation of the bronchitis phenotype was ≥ 12 pg/ml, the ICAM-1 level for emphysematous phenotype formation was ≥ 234.5 pg/ ml. The activity indexes of TNF-α and sICAM-1 are a more specific marker of the severity of SI and ED. An increase in the activity of vascular endothelial adhesion molecule type 1 and human platelet-derived growth factor AA in patients with COPD can be used as a diagnostic marker for the development of ED.
Conclusion. Diagnostic significance of TNF-α and ICAM-1 biomarkers for differentiating between bronchitis and emphysematous phenotypes of COPD is confirmed.
Keywords: emphysematous phenotype, bronchitis phenotype, systemic inflammation, chronic obstructive pulmonary disease, endothelial dysfunction
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About the Autors

Tatyana V. Tayutina, MD, PhD (Medicine), associate professor, head of the Department of outpatient and emergency therapy, Rostov State Medical University of the Ministry of Healthcare of Russia. Address: 344022, Rostov-on-Don, 29 Nakhichevansky Lane.
E-mail: tarus76@mail.ru
ORCID: https://orcid.org/0000-0002-5421-4202
Sergey V. Shlyk, MD, Dr. Sci. (Medicine), professor, head of the Department of medical law, public health and healthcare, Rostov State Medical University of the Ministry of Healthcare of Russia. Address: 344022, Rostov-on-Don, 29 Nakhichevansky Lane.
E-mail: molodoy.uchenyy@mail.ru
ORCID: https://orcid.org/0000-0003-3070-8424


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