Background
The increasing trend of Chronic Obstructive Pulmonary Disease (COPD) in becoming the third leading cause of deaths by 2020 is of great concern, globally as well as in India. Dysregulation of the protease/anti-protease balance in COPD has been reported to cause tissue destruction, inflammation and airway remodelling; which are peculiar characteristics of COPD. Therefore, it is imperative to explore various serum proteases involved in COPD pathogenesis, as candidate biomarkers.
Methods
The study was conducted on stable COPD patients, where we qualitatively and quantitatively analysed various serum proteases by ELISA and mass-spectrometry techniques. Statistical analysis for estimation of p-value was performed using unpaired t-test with 95% confidence interval.
Results
Amongst the significantly elevated proteases in COPD patients vs the controls- neutrophil elastase (NE) [P = 0.0241], caspase-7 [P < 0.0001] and matrix metalloprotease-2 (MMP-2) [P < 0.0001] were observed, along with increased levels of reactive oxygen species (ROS) [P < 0.0001]. The serum dipeptidyl peptidase-IV (DPP-IV) [P < 0.0006) concentration was decreased in COPD patients as compared to controls. Interestingly, a distinct elevation in MMP-2 was observed only in COPD patients, but not in Asthma, as compared to controls. Mass spectrometry analysis further identified significant alterations (fold-change) in various proteases, anti-proteases and signalling mediators.
Conclusions
The preliminary study of various serum proteases in stable COPD patients identified elevated MMP-2 as a candidate biomarker for COPD, subject to its validation in large cohort studies.