Fracción gamma del proteinograma y agudizaciones de la enfermedad pulmonar obstructiva crónica / Gamma globulin fraction of the proteinogram and chronic obstructive pulmonary disease exacerbations

Objetivos: Se pretende evaluar los niveles de la fracción de gammaglobulinas en suero como un marcador biológico para valorar la gravedad y predecir la mortalidad y nuevas agudizaciones en los pacientes ingresados por una agudización de la EPOC. Pacientes y métodos: El estudio VIRAE es una cohorte de pacientes ingresados por una agudización de probable causa infecciosa de la EPOC en un período de 2 años. Se analizaron los niveles de la fracción de gammaglobulinas del proteinograma en 120 pacientes. Se evaluaron los principales indicadores clínicos de gravedad. Se compararon las características principales en 2 grupos (mayor o menor de 6,6g/dl de la fracción gamma del proteinograma). Resultados: Los niveles de la fracción gamma del proteinograma se correlacionan con el valor del FEV1 (p=0,009), la PCR (p=0,04) y el número de reingresos a los 6 meses de la hospitalización (p=0,04). Se demuestra una buena asociación con la escala GOLD, el índice BODE y la escala de disnea de mMRC; y también con el tratamiento con corticoides orales y la oxigenoterapia domiciliaria. No hemos observado que sea un buen predictor de mortalidad, aun observando una mayor mortalidad al año del ingreso hospitalario en los pacientes con niveles bajos. Conclusiones: Los niveles de la fracción de gammaglobulinas en el proteinograma tienen una buena correlación con el FEV1. Además, se asocian a una mayor gravedad de los pacientes con EPOC. Este biomarcador sencillo puede ser útil para identificar pacientes de alto riesgo (AU)

Objectives: To evaluate the levels of the serum gamma globulin fraction in proteinograms as a biomarker to assess the severity, and to predict the mortality and new exacerbations in patients admitted for an exacerbation of a COPD. Patients and methods: The VIRAE study was carried out on a cohort of patients hospitalized for an exacerbation of probable infectious origin of COPD over a period of 2 years. The levels of the serum gamma globulin fraction were analyzed in the proteinogram of 120 patients. The main clinical indicators of severity were also evaluated. Key features were compared in 2 groups (gamma fraction in the proteinogram greater or less than 6.6g/dl). Results: The levels of the serum gamma fraction in the proteinogram correlated with the FEV1 (P=.009), the CRP (P=.04), and the number of readmissions after 6 months of hospitalization (P=.04). We observed a good association with the GOLD scale, the BODE index and the mMRC dyspnea scale; and also with treatment with oral corticoids and home oxygen therapy. We did not find it to be a good predictor of mortality, despite observing increased mortality rates one year after hospital admission in patients with low levels of the factor. Conclusions: The levels of the gamma globulin fraction in proteinograms has a good correlation with the FEV1. In addition, they are associated with a greater severity of patients with COPD. This simple biomarker may be useful in identifying high-risk patients (AU)

Gamma globulin fraction of the proteinogram and chronic obstructive pulmonary disease exacerbations. / Fracción gamma del proteinograma y agudizaciones de la enfermedad pulmonar obstructiva crónica.

OBJECTIVES: To evaluate the levels of the serum gamma globulin fraction in proteinograms as a biomarker to assess the severity, and to predict the mortality and new exacerbations in patients admitted for an exacerbation of a COPD. PATIENTS AND METHODS: The VIRAE study was carried out on a cohort of patients hospitalized for an exacerbation of probable infectious origin of COPD over a period of 2 years. The levels of the serum gamma globulin fraction were analyzed in the proteinogram of 120 patients. The main clinical indicators of severity were also evaluated. Key features were compared in 2 groups (gamma fraction in the proteinogram greater or less than 6.6g/dl). RESULTS: The levels of the serum gamma fraction in the proteinogram correlated with the FEV1 (P=.009), the CRP (P=.04), and the number of readmissions after 6 months of hospitalization (P=.04). We observed a good association with the GOLD scale, the BODE index and the mMRC dyspnea scale; and also with treatment with oral corticoids and home oxygen therapy. We did not find it to be a good predictor of mortality, despite observing increased mortality rates one year after hospital admission in patients with low levels of the factor. CONCLUSIONS: The levels of the gamma globulin fraction in proteinograms has a good correlation with the FEV1. In addition, they are associated with a greater severity of patients with COPD. This simple biomarker may be useful in identifying high-risk patients.