Study of blood desmosine level in patients with COPD exacerbation in relation to severity

Desmosine (DES), a cross linking amino-acid unique to mature elastin is expected to increase in proportion to the recruitment and activation of the inflammatory cells induced by smoking, exposure to biomass fuel smoke etc., or during acute exacerbations of COPD. Therefore, it could be investigated as a biomarker of the stable disease and during exacerbations. The study aimed to evaluate blood DES level in COPD exacerbation as well as in the stable state, and to assess its relation to severity of exacerbation. The study included 20 COPD patients and 20 healthy controls all individuals were subjected to chest radiograph, spirometric pulmonary function, arterial oxygen saturation (SapO2), arterial blood gases (ABG, patients only), and ELISA – based blood DES level assay which was done once in controls and twice – in COPD patients, both during exacerbation and one month later after being stable. DES level was more elevated, with high statistical significance, in COPD patients (both during exacerbation and in the stable state) compared to the control subjects, as well as it was significantly higher in COPD patients during exacerbation than in the same patients’ group after being stable. The DES level showed significant negative correlation with FEV1% in stable COPD and significant positive correlation with the severity of COPD exacerbation. Blood DES level as a marker of elastin degradation was elevated in stable COPD with more rise during exacerbation indicating that exacerbations could add more lung destruction leading to further deterioration of the lung function.