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Persistent Systemic Inflammation is Associated with Poor Clinical Outcomes in COPD: A Novel Phenotype

Open access
Agustí, Alvar, Edwards, Lisa D., Rennard, Stephen I., MacNee, William, Tal-Singer, Ruth, Miller, Bruce E., Vestbo, Jørgen, Lomas, David A., Calverley, Peter M. A., Wouters, Emiel, Crim, Courtney, Yates, Julie C., Silverman, Edwin K., Coxson, Harvey O., Bakke, Per, Mayer, Ruth J., Celli, Bartolome, for the Evaluation of COPD Longitudinally to Identify Predictive Surrogate Endpoints (ECLIPSE) Investigators·2012·PLoS ONE

Abstract

BACKGROUND: Because chronic obstructive pulmonary disease (COPD) is a heterogeneous condition, the identification of specific clinical phenotypes is key to developing more effective therapies. To explore if the persistence of systemic inflammation is associated with poor clinical outcomes in COPD we assessed patients recruited to the well-characterized ECLIPSE cohort (NCT00292552). METHODS AND FINDINGS: Six inflammatory biomarkers in peripheral blood (white blood cells (WBC) count and CRP, IL-6, IL-8, fibrinogen and TNF-α levels) were quantified in 1,755 COPD patients, 297 smokers with normal spirometry and 202 non-smoker controls that were followed-up for three years. We found that, at baseline, 30% of COPD patients did not show evidence of systemic inflammation whereas 16% had persistent systemic inflammation. Even though pulmonary abnormalities were similar in these two groups, persistently inflamed patients during follow-up had significantly increased all-cause mortality (13% vs. 2%, p<0.001) and exacerbation frequency (1.5 (1.5) vs. 0.9 (1.1) per year, p<0.001) compared to non-inflamed ones. As a descriptive study our results show associations but do not prove causality. Besides this, the inflammatory response is complex and we studied only a limited panel of biomarkers, albeit they are those investigated by the majority of previous studies and are often and easily measured in clinical practice. CONCLUSIONS: Overall, these results identify a novel systemic inflammatory COPD phenotype that may be the target of specific research and treatment.

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Metadata

Authors
Agustí, A., Edwards, L. D., Rennard, S. I., MacNee, W., Tal-Singer, R., Miller, B. E., Vestbo, J., Lomas, D. A., Calverley, P. M. A., Wouters, E., Crim, C., Yates, J. C., Silverman, E. K., Coxson, H. O., Bakke, P., Mayer, R. J., Celli, B., & for the Evaluation of COPD Longitudinally to Identify Predictive Surrogate Endpoints (ECLIPSE) Investigators
Venue
PLoS ONE
Published
2012-05-18
Volume
7
Issue
5
Pages
e37483
ISSN
1932-6203 (ISSN-L)
OpenAlex
W2161713331
Cited by
848
References
51
FWCI
64.27
Type
journal article
Language
en
Open access
gold

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CoChat. (2026). Citation check: Persistent Systemic Inflammation is Associated with Poor Clinical Outcomes in COPD: A Novel Phenotype. https://app.cochat.ai/papers/10.1371/journal.pone.0037483
The paper
Agustí, A., Edwards, L. D., Rennard, S. I., MacNee, W., Tal-Singer, R., Miller, B. E., Vestbo, J., Lomas, D. A., Calverley, P. M. A., Wouters, E., Crim, C., Yates, J. C., Silverman, E. K., Coxson, H. O., Bakke, P., Mayer, R. J., Celli, B., & for the Evaluation of COPD Longitudinally to Identify Predictive Surrogate Endpoints (ECLIPSE) Investigators. (2012). Persistent Systemic Inflammation is Associated with Poor Clinical Outcomes in COPD: A Novel Phenotype. PLoS ONE. https://doi.org/10.1371/journal.pone.0037483

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Bibliographic data: Semantic Scholar, OpenAlex, Crossref.

Contains information from the Semantic Scholar Academic Graph Datasets, made available under the ODC Attribution License (ODC-BY 1.0).

Semantic Scholar’s data is described in: Kinney, R., et al. (2023). The Semantic Scholar Open Data Platform. arXiv:2301.10140.