Systemic inflammatory profile and response to anti-tumor necrosis factor therapy in chronic obstructive pulmonary disease

Loza, Watt Rosemary, Baribaud Frédéric, Barnathan, Rennard

Description

Chronic obstructive pulmonary disease (COPD) is characterized by progressive worsening of airflow limitation associated with abnormally inflamed airways in older smokers. Despite correlative evidence for a role for tumor necrosis factor-alpha in the pathogenesis of COPD, the anti-tumor necrosis factor-alpha, infliximab did not show clinical efficacy in a double-blind, placebo-controlled, phase II clinical trial. This study sought to evaluate the systemic inflammatory profile associated with COPD and to assess the impact of tumor necrosis factor neutralization on systemic inflammation. Methods Serum samples (n = 234) from the phase II trial were collected at baseline and after 24 weeks of placebo or infliximab. Additionally, baseline serum samples were obtained from an independent COPD cohort (n = 160) and 2 healthy control cohorts (n = 50; n = 109). Serum concentrations of a broad panel of inflammation-associated analytes were measured using a 92-analyte multiplex assay. Results Twenty-five proteins were significantly elevated and 2 were decreased in COPD, including highly elevated CD40 ligand, brain-derived neurotrophic factor, epidermal growth factor, acute-phase proteins, and neutrophil-associated proteins. This profile was largely independent of smoking status, age, and clinical phenotype. The majority of these associations of serum analytes with COPD are novel findings. Increased serum creatine kinase-muscle/brain and myoglobin correlated modestly with decreased forced expiratory volume at 1 second, suggesting cardiac involvement. Infliximab did not affect this systemic inflammatory profile. Conclusions A robust systemic inflammatory profile was associated with COPD. This profile was generally independent of disease severity. Because anti-tumor necrosis factor-alpha did not influence systemic inflammation, how to control the underlying pathology beyond symptom suppression remains unclear. Trial Registration ClinicalTrials.gov, No .: NCT00056264 .

Sujets

• Chronic obstructive pulmonary disease
• Inflammation
• Tumor necrosis factor-alpha
• Infliximab

Informations

• Publié par: biomed
• Publié le: 01 janvier 2012
• Nombre de lectures: 5
• Langue: English
• Poids de l'ouvrage: 1 Mo

Extrait

Lozaet al.Respiratory Research2012,13:12 http://respiratoryresearch.com/content/13/1/12

R E S E A R C HOpen Access Systemic inflammatory profile and response to antitumor necrosis factor therapy in chronic obstructive pulmonary disease 1* 21 23 Matthew J Loza, Rosemary Watt , Frédéric Baribaud , Elliot S Barnathanand Stephen I Rennard

Abstract Background:Chronic obstructive pulmonary disease (COPD) is characterized by progressive worsening of airflow limitation associated with abnormally inflamed airways in older smokers. Despite correlative evidence for a role for tumor necrosis factoralpha in the pathogenesis of COPD, the antitumor necrosis factoralpha, infliximab did not show clinical efficacy in a doubleblind, placebocontrolled, phase II clinical trial. This study sought to evaluate the systemic inflammatory profile associated with COPD and to assess the impact of tumor necrosis factor neutralization on systemic inflammation. Methods:Serum samples (n = 234) from the phase II trial were collected at baseline and after 24 weeks of placebo or infliximab. Additionally, baseline serum samples were obtained from an independent COPD cohort (n = 160) and 2 healthy control cohorts (n = 50; n = 109). Serum concentrations of a broad panel of inflammation associated analytes were measured using a 92analyte multiplex assay. Results:Twentyfive proteins were significantly elevated and 2 were decreased in COPD, including highly elevated CD40 ligand, brainderived neurotrophic factor, epidermal growth factor, acutephase proteins, and neutrophil associated proteins. This profile was largely independent of smoking status, age, and clinical phenotype. The majority of these associations of serum analytes with COPD are novel findings. Increased serum creatine kinase muscle/brain and myoglobin correlated modestly with decreased forced expiratory volume at 1 second, suggesting cardiac involvement. Infliximab did not affect this systemic inflammatory profile. Conclusions:A robust systemic inflammatory profile was associated with COPD. This profile was generally independent of disease severity. Because antitumor necrosis factoralpha did not influence systemic inflammation, how to control the underlying pathology beyond symptom suppression remains unclear. Trial Registration:ClinicalTrials.gov,No.: NCT00056264. Keywords:chronic obstructive pulmonary disease, inflammation, biological biomarkers, tumor necrosis factoralpha, infliximab

Background Chronic obstructive pulmonary disease (COPD) is a complex syndrome characterized by progressive expira tory airflow loss associated with abnormal inflammation in the lungs. In addition to symptoms related to airway pathology–including cough, excessive sputum, and dys pnea–COPD has systemic manifestations, one of which

* Correspondence: [e-mail] 1 Immunology Biomarkers, Janssen Research & Development, LLC, Malvern, PA, USA Full list of author information is available at the end of the article

may be exercise limitation related to muscle weakness [1]. Systemic inflammation has been described in COPD, including increased production of the potent inflammatory mediator tumor necrosis factor (TNF) alpha [25]. Increased TNFalpha production has also been associated with muscle loss and weakness in COPD [57]. Although no natural animal models of COPD exist, intraperitoneal injection of TNFalpha in rats leads to emphysema,[8] which may resemble the apoptosis of alveolar cells observed in COPD patients with emphysema [9,10].

© 2012 Loza et al; licensee BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.