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Multicenter Study
. 2018 Mar 27;19(1):47.
doi: 10.1186/s12931-018-0755-6.

Plasma YKL-40 and NGAL are useful in distinguishing ACO from asthma and COPD

Jing Wang  1 , Huajie Lv  1 , Zhuang Luo  2 , Shan Mou  1 , Jing Liu  1 , Chang Liu  1 , Shiying Deng  3 , Youfan Jiang  1 , Jiachen Lin  4 , Chengzhou Wu  5 , Xianhong Liu  6 , Jinzhi He  7 , Depeng Jiang  8
Affiliations
Multicenter Study

Plasma YKL-40 and NGAL are useful in distinguishing ACO from asthma and COPD

Jing Wang et al. Respir Res. .

Abstract

Background: Asthma-chronic obstructive pulmonary disorder (COPD) overlap (ACO) is characterized by the coexistence of features of both asthma and COPD and is associated with rapid progress and a poor prognosis. Thus, the early recognition of ACO is crucial.

Objectives: We sought to explore the plasma levels of biomarkers associated with asthma (periostin, TSLP and YKL-40), COPD (NGAL) and their possible correlation with lung function, the bronchodilator response and radiographic imaging in patients with asthma, COPD and with features of ACO.

Methods: We enrolled 423 subjects from 6 clinical centers. All participants underwent blood collection, lung function measurements, bronchodilator response tests and high-resolution CT. Correlations of the plasma biomarkers with lung function, the bronchodilator response and percentemphysema were calculated by Spearman's rank correlation and multivariate stepwise regressionanalysis.

Results: 1) Patients with features of ACO had lower plasma YKL-40 than COPD patients and a moderate elevated plasma level of NGAL compared with asthma patients. 2) Patients with features of ACO had an intermediate degree of airflow obstruction, the bronchodilator response and emphysema between patients with COPD and asthma. 3) Plasma YKL-40 was negatively correlated with lung function and with the bronchodilator response, and plasma NGAL was positively correlated with the extent of emphysema.

Conclusions: Plasma YKL-40 is a promising candidate for distinguishing between patients with features of ACO and COPD patients, while plasma NGAL may be a valuable biomarker for differentiating between patients with features of ACO and asthma patients.

Clinical trial registration: ChiCTR-OOC-16009221.

Keywords: Asthma; Asthma COPD overlap (ACO); Chronic obstructive pulmonary disease; NGAL; YKL-40.

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Conflict of interest statement

Ethics approval and consent to participate

Ethics committee approval was obtained for the Second Clinical Hospital of Chongqing Medical University (reference number: 2015(68)), and all subjects provided written informed consent.

Consent for publication

Not applicable.

Competing interests

The authors declare that they have no competing interests.

Publisher’s Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Figures

Fig. 1
Fig. 1
Plasma levels of a) YKL-40, b) NGAL, c) POSTN and d) TSLP in healthy control subjects and patients with asthma, ACO and COPD. Note:*: p < 0.05; **: p < 0.01; ***: p < 0.001. Abbreviations: ACO: asthma–COPD overlap; COPD: chronic obstructive pulmonary disease; YKL-40:chitinase-3-like protein 1; NGAL: neutrophil gelatinase-associated lipocalin, POSTN: Periostin;TSLP: Thymic stromal lymphopoietin
See this image and copyright information in PMC

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