Progranulin is a novel biomarker for predicting an acute exacerbation of chronic obstructive pulmonary disease.

ABSTRACT

BACKGROUND: Progranulin is a pleiotropic glycosylated protein precursor that plays an important role in inflammation. Limited data exist regarding the role of progranulin in the acute exacerbation of chronic obstructive pulmonary disease (AECOPD). OBJECTIVES: The study is to assess the efficiency of progranulin as a circulating biomarker of AECOPD. METHODS: The plasma progranulin levels were measured and compared in patients with AECOPD (n = 52), patients with stable COPD (n = 56), and healthy controls (n = 36). In patients with AECOPD, plasma progranulin levels were measured repeatedly on the last day of hospitalization. Demographical data, pulmonary function, and laboratory parameters were recorded. RESULTS: Patients with AECOPD had higher plasma progranulin levels than both stable COPD patients and healthy controls (158.77 ± 48.17, 109.00 ± 25.05, 93.67 ± 14.71 ng/mL, respectively; P < .001). In patients with AECOPD, the plasma progranulin levels significantly decreased on the last day of hospitalization compared with those on the first day of hospitalization (138.51 ± 44.68 vs. 158.77 ± 48.17 ng/mL, P = .042). The progranulin levels were negatively correlated to FEV1%pred but positively correlated to neutrophil-to-lymphocyte ratio and C-reactive protein in all patients with COPD. Multivariate logistic regression and ROC analysis revealed progranulin (odds ratio 1.05, 95% confidence interval 1.03-1.08, P < .001) as an independent predictor of AECOPD, with an area under the curve of 0.82. CONCLUSIONS: Progranulin may be a valuable blood biomarker of AECOPD and progranulin may be involved in the pathogenesis of AECOPD by disturbing inflammatory responses.