Role of soluble urokinase type plasminogen activator receptor suPAR in chronic obstructive pulmonary disease

Abstract

Soluble urokinase type plasminogen activator receptor is a marker of pulmonary inflammation associated with lung parenchymal destruction with fibrosis of small airways leading to airway limitation with lung function decline Since suPAR is a stable marker clinically its being used to predict the prognosis of sepsis heart failure and adult respiratory distress syndrome However the clinical utility of suPAR in COPD patients is limited because there are hardly any Indian studies on suPAR in stable COPD patients Hence this study was carried out to evaluate soluble urokinase type plasminogen activator receptor levels in chronic obstructive pulmonary disease This longitudinal study was carried out in 200 stable COPD subjects aged between 35 and 65 years After obtaining informed consent lung function tests including respiratory defence mechanism were done on a quarterly basis for a period of one year The blood samples were collected to assess serum suPAR and CRP using ELISA kits at baseline and at the end of the study The mean plus or minus SD for suPAR were 2 point 18 plus or minus 0 point 44 2 point 75 plus or minus 0 point 31 3 point 68 plus or minus 0 point 34 4 point 65 plus or minus 0 point 29 during first visit with p equal to 0 point 000 and 2 point 93plus or minus 0point 87 for 3 point 86plus or minus 0 point 67 for 5 plus or minus 0 point 53 for 5 point 82 plus or minus 0 point 50 during fourth visit with p equal to 0 point 000 among mild moderate severe and very severe COPD respectively during each visit. Serum suPAR has statistically significant correlation with FEV1 percent 6MWD mucociliary clearance test phagocytic activity among very severe COPD grade The present longitudinal study showed that as severity of COPD worsens suPAR level increases with a concomitant and significant decline in lung function test which indicates the role of suPAR in the prognosis and early of COPD severity Hence serum suPAR could be used as a marker of pulmonary inflammation to grade COPD severity compared to routinely assessed