Serum MMP3 and IL1-RA levels may be useful biomarkers for detecting asthma and chronic obstructive pulmonary disease overlap in patients with asthma

Kazufumi Takada; Maho Suzukawa; Hiroyuki Tashimo; Nobuharu Ohshima; Yuma Fukutomi; Nobuyuki Kobayashi; Masami Taniguchi; Masaki Ishii; Masahiro Akishita; Ken Ohta

doi:10.1016/j.waojou.2023.100840

Serum MMP3 and IL1-RA levels may be useful biomarkers for detecting asthma and chronic obstructive pulmonary disease overlap in patients with asthma

World Allergy Organ J. 2023 Nov 9;16(11):100840. doi: 10.1016/j.waojou.2023.100840. eCollection 2023 Nov.

Authors

Kazufumi Takada^{1

2}, Maho Suzukawa¹, Hiroyuki Tashimo³, Nobuharu Ohshima⁴, Yuma Fukutomi⁵, Nobuyuki Kobayashi⁶, Masami Taniguchi^{5

7}, Masaki Ishii², Masahiro Akishita², Ken Ohta^{1

8}

Affiliations

¹ Clinical Research Center, National Hospital Organization Tokyo National Hospital, Tokyo, 204-8585, Japan.
² Department of Geriatric Medicine, Graduate School of Medicine, University of Tokyo, Tokyo, 113-8655, Japan.
³ Asthma, Allergy and Rheumatology Center, National Hospital Organization Tokyo National Hospital, Tokyo, 204-8585, Japan.
⁴ Department of Respiratory Medicine, National Hospital Organization Tokyo National Hospital, Tokyo, 204-8585, Japan.
⁵ Clinical Research Center, National Hospital Organization Sagamihara National Hospital, Kanagawa, 252-0392, Japan.
⁶ Fureai Machida Hospital, Tokyo, 194-0215, Japan.
⁷ Shonan Kamakura General Hospital, Kanagawa, 247-8533, Japan.
⁸ Japan Anti-Tuberculosis Association, JATA Fukujuji Hospital, Tokyo, 204-8522, Japan.

Abstract

Background: Asthma and chronic obstructive pulmonary disease (COPD) overlap (ACO) is characterized by concurrent features of asthma and COPD. Since disease pathogenesis, severities, and treatments differ between asthma and ACO, it is important to differentiate them.

Objective: To clarify and compare the characteristics of ACO and asthma and identify the serum biomarkers for differentiating them, especially in older patients.

Methods: This study used the data of 639 participants from the nationwide cohort study, the NHOM-Asthma study, an asthma registry in Japan, with complete information on smoking history, respiratory function, and serum biomarkers. ACO was defined as the self-reported comorbidity of COPD or emphysema, or with obstructive pulmonary function and smoking history (pack-years≥10). The clinical characteristics of patients with ACO and asthma without COPD were compared. The serum biomarkers for differentiation were examined using receiver operating characteristic curves and multivariable analysis. The associations between the biomarkers and age were also analyzed.

Results: Of the 639 asthma patients, 125 (19.6%) were diagnosed with ACO; these patients were older and male-dominant and had a higher prevalence of comorbidities such as hypertension, diabetes, and stroke. Among the serum biomarkers that were significantly different between ACO and asthma without COPD, the YKL-40/CHI3L1, MMP3, and IL-1RA levels showed a high area under the curve for discriminating ACO. Only the MMP3 and IL-1RA levels were significantly higher among ACO patients, regardless of age and sex; the YKL-40/CHI3L1 levels were not different due to the effect of age.

Conclusion: MMP3 and IL-1RA may be useful serum biomarkers for distinguishing ACO from asthma.

Keywords: Asthma-chronic obstructive pulmonary disease overlap; Interleukin 1 receptor antagonist; Matrix metalloproteinase 3; Serum marker.