Association of plasma netrin-1 level with inflammatory balance and comorbidities in patients with acute exacerbation of COPD

• Published in: Tüberküloz ve toraks Vol. 69; no. 1; pp. 30 - 38
• Main Authors: Kerget, Buğra, Afşin, Dursun Erol, Kerget, Ferhan, Koçak, Abdullah Osman, Aksakal, Alperen, Kızıltunç, Ahmet, Araz, Ömer, Yılmazel Uçar, Elif, Akgün, Metin
• Format: Journal Article
• Language: English
• Published: Turkey 01-03-2021
• Subjects: Adult; Aged; C-Reactive Protein - analysis; Case-Control Studies; Comorbidity; Female; Forced Expiratory Volume; Humans; Inflammation - immunology; Inflammation - physiopathology; Lung - physiopathology; Male; Middle Aged; Netrin-1 - metabolism; Plasma - immunology; Pulmonary Disease, Chronic Obstructive - immunology; Pulmonary Disease, Chronic Obstructive - physiopathology; Respiratory Function Tests; Smoking - immunology; Vital Capacity
• ISSN: 0494-1373
• DOI: 10.5578/tt.20219904

Chronic obstructive pulmonary disease (COPD) is a common lung disease characterized by airflow restriction and systemic inflammation. Netrin-1 is a protein mainly produced in the central nervous system and has proven anti-inflammatory activity. The aim of this study was to determine netrin-1 level and its relationship with comorbidities in patients with acute exacerbation of COPD.
The study included 232 patients aged over 40 years who were divided into 3 groups: Group 1: ex-smokers (≥ 20 pack-years) with COPD hospitalized for COPD exacerbation (n= 142), Group 2: current-smokers (≥ 20 pack-years) without COPD (n= 30), Group 3: a control group comprising healthy non-smokers (n= 60). Plasma netrin-1 levels were measured using commercial enzyme-linked immunosorbent assay (ELISA) kit.
There were significant differences in forced expiratory volume in 1 second (FEV1), forced vital capacity (FVC), FEV1/FVC, C-reactive protein (CRP), and plasma netrin-1 levels between patients with acute exacerbation of COPD and current smokers without COPD, healthy controls (p= 0.001 for all). Netrin-1 levels at discharge were lower in COPD patients with diabetes mellitus (DM) compared to nondiabetic COPD patients (p= 0.01). Weak correlation was observed between netrin-1 level at admission and FEV1, FVC, partial pressure of oxygen, and CRP levels (r= 0.394, p= 0.01; r= -0.366, p= 0.01; r= -0.19, p= 0.05; r= 0.306, p= 0.01). Netrin-1 level at admission was also moderately correlated with smoking history (pack-years) (r= 0.579, p= 0.01).
Netrin-1 was elevated in acute exacerbation of COPD and may be an important element in inflammatory balance. Patients with both COPD and DM were found to have lower netrin-1 levels at discharge after resolution of the acute exacerbation.