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Collagen degradation and formation are elevated in exacerbated COPD compared to stable disease.

著者 Schumann DM , Leeming D , Papakonstantinou E , Blasi F , Kostikas K , Boersma W , Louis R , Milenkovic B , Aerts J , Sand JMB , Wouters EFM , Rohde G , Prat C , Torres A , Welte T , Tamm M , Karsdal M , Stolz D
Chest.2018 Jun 29 ; ():.
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The role of the extracellular matrix (ECM) structure and remodelling of thereof in lung diseases is gaining importance. Pathology-related changes in the ECM turnover may result in deleterious changes in lung architecture leading to disease in the small airways. Here, degradation fragments of type I (C1M), type IV (α1 chain, C4M2), and type IV (α3 chain, C4Ma3) collagen, all degraded by metalloproteinases (MMPs) and the pro-form of collagen type V (PRO-C5) were investigated and associated with chronic obstructive pulmonary disease (COPD) severity and outcome. In a prospective, observational, multicenter study including 498 patients with COPD GOLD stage 2 to 4, ECM markers were assessed in serum at stable state, exacerbation and at follow up, 4 weeks after exacerbation. At stable state, there was a significant inverse association between FEV %predicted and C1M, C4Ma3 and Pro-C5. C1M, C4M2, C4Ma3 and Pro-C5 were associated with body mass index, airflow obstruction, dyspnea and exercise capacity (BODE) index and the modified medical research council (MMRC) score. C1M, C4M2, C4Ma3 and Pro-C5 were significantly increased from stable state to exacerbation and decreased at follow-up. Furthermore, the biomarkers were significantly higher during severe exacerbation compared to moderate exacerbation. Multivariate analysis adjusted for body mass index, MMRC score, unadjusted Charlson score, and FEV% predicted, showed a significant influence of C1M, C4Ma3 and C4M2 on time to exacerbation. None of the biomarkers were predictors for mortality. Serologically assessed collagen remodelling appears to play a significant role in COPD severity (airflow limitation, dyspnea) and disease outcome (time to exacerbation, and prognosis as assessed by the BODE index).
PMID: 29966667 [PubMed - as supplied by publisher]
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