DOI: 10.36347/sjams.2017.v05i11.011

Pages: 4353-4365

Chronic obstructive pulmonary disease (COPD) arises from an interaction between various causal factors, both host factors and environmental exposures. There is increased numbers of neutrophils, macrophages, and T lymphocytes (CD8 more than CD4) in the lungs. Reactive oxygen and nitrogen species are released from inflammatory cells. Many markers of oxidative stress and systemic inflammation are increased in stable COPD. The level of these markers increases further during acute exacerbation. Single global marker in COPD is still a concept and may not be applicable to a complex, multicomponent disorder like COPD. There are various markers in COPD for measurement of the lung function. Forced expiratory volume in 1 second (FEV1) is the usual marker. Additional markers are needed to provide a more comprehensive and clinically meaningful assessment so as to provide a more informed basis for treatment decisions. Markers related to inflammatory processes, structural changes and systemic effects could yield valuable information to complement that provided by FEV1 for airflow limitation. Now there has been a shift in the bio markers from the lung sources toward blood specimens. Increased levels of various inflammatory proteins such as C-reactive protein (CRP), Tumor necrosis factors- (TNF) and Interleukin-6 (IL-6) are found in systemic circulation in COPD patients that can be used as markers of status of COPD. Copeptin and procalcitonin have emerged as prognostic biomarkers in acute exacerbation of COPD.