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A Journal on Diseases of the Respiratory System
Official Journal of the Italian Society of Thoracic Endoscopy
Indexed/Abstracted in: EMBASE, Scopus, Emerging Sources Citation Index
REVIEWS ADVANCES IN CHRONIC OBSTRUCTIVE PULMONARY DISEASE (COPD)
Minerva Pneumologica 2009 March;48(1):31-44
Biomarkers and chronic obstructive pulmonary disease
Lee J., Sin D. D.
Providence Heart and Lung Institute St. Paul’s Hospital James Hogg iCAPTURE Centre for Cardiovascular and Pulmonary Research
University of British Columbia Vancouver, BC, Canada
Chronic obstructive pulmonary disease (COPD) affects over 80 million people worldwide and is responsible for nearly 3 million deaths per year, making it the fourth leading cause of mortality. Over the next 10 to 15 years, the mortality from COPD is expected to double. Despite the growing health burden of COPD, there are no available drugs that can modify disease progression or reduce mortality. The discovery of novel biomarkers that can be used to risk-stratify patients, serve as intermediate end points for phase I and II trials and track disease progression is desperately needed to accelerate drug development of life-preserving therapies. Blood is the most attractive source for biomarker discovery as it is relatively easy to procure, its measurements can be standardized and high throughput assays are feasible. To date, blood C-reactive protein has been the most well studied. However, although its plasma/serum levels correlate with hard outcomes such as hospitalization and mortality, it lacks specificity for COPD, limiting its value. Pneumoproteins such as surfactant protein-D and Clara Cell Protein-16 are promising lung-specific proteins. However, many unanswered questions remain regarding these proteins that currently limit their use in clinical practice. In this paper, the authors discuss the current knowledge of biomarker discovery in COPD and provide the strengths and limitations of the candidate biomarkers.