NEW YORK (Reuters Health) Dec 29 - Patients with chronic obstructive pulmonary disease (COPD) have reduced serum levels of Clara cell secretory protein-16 (CC-16), according to a report in the December issue of Thorax.
CC-16 acts as an immunosuppressant that provides protection against oxidative stress and carcinogenesis, the authors explain, but previous studies of CC-16 levels in COPD have yielded conflicting results.
Dr. D. A. Lomas from the University of Cambridge, UK and colleagues evaluated serum CC-16 as a potential biomarker for COPD using data from the Evaluation of COPD Longitudinally to Identify Predictive Surrogate Endpoints (ECLIPSE) study.
Median serum CC-16 levels were significantly lower for current and former smokers with COPD than for current and former smokers without airflow obstruction or for nonsmoking controls, the authors report.
Serum CC-16 levels did not correlate with COPD severity in the overall cohort, the researchers note, but there was a weak correlation between serum CC-16 and COPD severity in former smokers.
Similarly, there was no correlation between serum CC-16 and the presence of reversible airflow obstruction in the overall COPD cohort, but former smokers with COPD had significantly higher serum CC-16 levels if they also had reversible airflow obstruction.
"CC-16 cannot be used to screen populations of individuals for COPD and cannot be used as a surrogate for lung function testing to evaluate the presence of reversible airflow obstruction," the investigators conclude. However, "serum CC-16 may be useful in longitudinal studies to assess epithelial repair or may be combined with other biomarkers to diagnose or monitor the progression of COPD."
"Given the clinical complexity of COPD -- which is really a syndrome with elements of bronchitis, airway hyperreactivity, pulmonary emphysema, and an inflammatory state in variable proportions -- it seems likely that multiple biomarkers will be required to characterize pathogenetic factors and their course over time," writes Dr. Gerard M. Turino from St. Luke's-Roosevelt Hospital, New York in a related editorial.
"Within the spectrum of biomarkers," Dr. Turino concludes, "CC-16 has the potential to indicate abnormal function of the Clara cell or Clara cell abnormalities in airway structure and function."
"However," he adds, "its usefulness will be limited unless the measured levels of CC-16 can be shown to reflect the presence and severity of airway dysfunction, normalcy, or injury to Clara cells and changes in these states with reasonable speed. To date, this has not been done."
Thorax 2008;63:1032-1034,1058-1063. 本人已认领该文编译，48小时后若未提交译文，请其他战友自由认领。 【粗译】
作者:admin@医学,生命科学 2011-05-01 05:11