Mass Spectrometry Proteomic Biomarkers Identify Acute Copd Exacerbations

Background: Confirming a clinical diagnosis of acute COPD exacerbation can be challenging and there is a growing need to identify molecular signatures that can differentiate between acute and stable COPD states. Aim: To identify plasma biomarkers associated with acute COPD exacerbations. Methods: A total of 98 samples obtained from 49 COPD patients recruited as part of the COPD-BEAT study and had plasma biomarkers measured using Tandem Mass Spectrometry during stable and acute exacerbations visits. Results: 1856 proteins in total identified including 1190 proteins with quantitation. Using non-parametric test and a false discovery rate of 0.5, 60 candidate biomarkers were associated with significant change between stable and exacerbations visits. 23/60 biomarkers increased with exacerbations, namely acute phase proteins: serum amyloid A-1 protein (SAA1), C-reactive protein (CRP) and serum amyloid A-2 protein (SAA2) with a fold increase of 8.14, 3.60 and 3.07, respectively. The remaining 37/60 proteins were decreased in concentration during exacerbations. Area Under the Curve (AUC) of a model with 4 proteomic candidate biomarkers panel is 0.79 (95% Confidence Interval= 0.70 - 0.88), Figure1. Conclusion: Mass proteomic analysis can identify plasma biomarkers to discriminate acute COPD exacerbations from stable state.