In conclusion, there are several biomarkers that show promise for use in differentiating bacterial from non-bacterial AECOPD, with serum CRP having the most convincing evidence. However, given the low number of studies identified and large amount of heterogeneity between studies, it is not possible to draw firm conclusions about the value of using biomarkers to identify bacterial exacerbations of COPD. Further well-powered high-quality studies are needed, especially on markers with some evidence of value such as serum CRP and PCT, and sputum IL-8, TNF-α, IL-1β, IL-6, MPO and NE.
COP: Chronic obstructive pulmonary disease; CCL: Chemokine ligand; CD: Cluster of differentiation; CRP: C-reactive protein; CXCL: C-X-C motif chemokine; ECP: Eosinophil cationic protein; GMCSF: Granulocyte–macrophage colony-stimulating factor; IFN: Interferon; IL: Interleukin; LDH: Lactate dehydrogenase; LTB4: Leukotriene-B4; MCP-1: Monocyte chemoattractant protein-1; MPO: Myeloperoxidase; NE: Neutrophil elastase; N/L: Neutrophil/lymphocyte; PSP/reg: Pancreatic stone protein/regenerating protein; PCT: Procalcitonin; PTX3: Pentraxin 3; ROS: Reactive oxygen species; SAA: Serum amyloid A; sICAM: Soluble intercellular adhesion molecule; sTREM-1: Soluble myeloid cell trigger receptor-1; SPD: Surfactant protein D; TNF: Tumour necrosis factor; TNFR: Tumour necrosis factor receptor; WBC: White blood cell.
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BMC Pulm Med. 2022;22(194) © 2022 BioMed Central, Ltd.