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      Tumor necrosis factor receptor 2 as a possible marker of COPD in smokers and ex-smokers

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          Abstract

          Introduction

          Oxidative stress and systemic inflammation are higher in smokers and patients with COPD; however, markers that may help differentiate between smokers and patients with COPD have not yet been identified. We hypothesized that tumor necrosis factor-alpha receptor (TNFR) and soluble form of the receptor for advanced glycation end products (sRAGE) can be indicators of COPD in asymptomatic patients.

          Patients and methods

          We evaluated 32 smokers (smoking history >10 pack-years), 32 patients with mild/moderate COPD (smokers and ex-smokers), and 32 never smokers. Concentrations of C-reactive protein (CRP), interleukin (IL)-6, TNFR1 and TNFR2, advanced glycation end products (AGEs), and the sRAGE were measured in serum.

          Results

          There were higher CRP and AGEs concentrations in smokers and in patients with COPD ( P<0.001 and P=0.01, respectively) compared to controls, without statistical difference between smokers and patients with COPD. Concentrations of sRAGE, IL-6, and TNFR1 did not differ between study groups. TNFR2 was significantly higher in patients with COPD than in smokers ( P=0.004) and controls ( P=0.004), and the presence of COPD ( P=0.02) and CRP ( P=0.001) showed a positive association with TNFR2. Positive associations for smoking ( P=0.04), CRP ( P=0.03), and IL-6 ( P=0.03) with AGEs were also found. The interaction variable (smoking × COPD) showed a positive association with IL-6.

          Conclusion

          Our data suggest that TNFR2 may be a possible marker of COPD in asymptomatic smokers and ex-smokers. Although smokers and patients with early COPD presented other increased systemic inflammation markers (eg, CRP) and oxidative stress (measured by AGEs), they did not differentiate smokers from COPD.

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          Most cited references 35

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          Clinical Significance of Symptoms in Smokers with Preserved Pulmonary Function.

          Currently, the diagnosis of chronic obstructive pulmonary disease (COPD) requires a ratio of forced expiratory volume in 1 second (FEV1) to forced vital capacity (FVC) of less than 0.70 as assessed by spirometry after bronchodilator use. However, many smokers who do not meet this definition have respiratory symptoms.
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            The multiligand receptor RAGE as a progression factor amplifying immune and inflammatory responses.

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              • Article: not found

              Body composition and mortality in chronic obstructive pulmonary disease.

              Survival studies have consistently shown significantly greater mortality rates in underweight and normal-weight patients with chronic obstructive pulmonary disease (COPD) than in overweight and obese COPD patients. To compare the contributions of low fat-free mass and low fat mass to mortality, we assessed the association between body composition and mortality in COPD. We studied 412 patients with moderate-to-severe COPD [Global Initiative for Chronic Obstructive Pulmonary Disease (GOLD) stages II-IV, forced expiratory volume in 1 s of 36 +/- 14% of predicted (range: 19-70%). Body composition was assessed by using single-frequency bioelectrical impedance. Body mass index, fat-free mass index, fat mass index, and skeletal muscle index were calculated and related to recently developed reference values. COPD patients were stratified into defined categories of tissue-depletion pattern. Overall mortality was assessed at the end of follow-up. Semistarvation and muscle atrophy were equally distributed among disease stages, but the highest prevalence of cachexia was seen in GOLD stage IV. Forty-six percent of the patients (n = 189) died during a maximum follow-up of 5 y. Cox regression models, with and without adjustment for disease severity, showed that fat-free mass index (relative risk: 0.90; 95% CI: 0.84, 0.96; P = 0.003) was an independent predictor of survival, but fat mass index was not. Kaplan-Meier and Cox regression plots for cachexia and muscle atrophy did not differ significantly. Fat-free mass is an independent predictor of mortality irrespective of fat mass. This study supports the inclusion of body-composition assessment as a systemic marker of disease severity in COPD staging.
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                Author and article information

                Journal
                Int J Chron Obstruct Pulmon Dis
                Int J Chron Obstruct Pulmon Dis
                International Journal of COPD
                International Journal of Chronic Obstructive Pulmonary Disease
                Dove Medical Press
                1176-9106
                1178-2005
                2017
                07 July 2017
                : 12
                : 2015-2021
                Affiliations
                [1 ]Department of Internal Medicine
                [2 ]Department of Pathology, Botucatu Medical School, UNESP – Univ Estadual Paulista, Botucatu Campus, Botucatu-São Paulo, Brazil
                Author notes
                Correspondence: Laura Miranda de Oliveira Caram, Department of Internal Medicine, Botucatu Medical School, UNESP – Univ Estadual Paulista, Botucatu Campus, Pneumology Area – UNESP, Distrito de Rubião Junior s/n, Botucatu 18618-970, São Paulo, Brazil, Tel +55 14 3880 1171, Fax +55 14 3882 2238, Email laucaram@ 123456hotmail.com
                Article
                copd-12-2015
                10.2147/COPD.S138558
                5511022
                © 2017 Caram et al. This work is published and licensed by Dove Medical Press Limited

                The full terms of this license are available at https://www.dovepress.com/terms.php and incorporate the Creative Commons Attribution – Non Commercial (unported, v3.0) License ( http://creativecommons.org/licenses/by-nc/3.0/). By accessing the work you hereby accept the Terms. Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed.

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                Original Research

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