Prostaglandin D2 Distinguishes Asthma and COPD from Asthma-COPD Overlap Syndrome

Scientist looking at blood specimen
Scientist looking at blood specimen
Turkish participants with asthma were found to be distinguishable from patients with asthma with chronic obstructive pulmonary disease overlap syndrome through blood levels of prostaglandin D2.

Levels of prostaglandin D2 (PG-D2) may be helpful for differentiating asthma and chronic obstructive pulmonary disease (COPD) from asthma-COPD overlap syndrome (ACOS), a study in the Journal of Asthma reports.

Researchers from the University of Health Sciences, Istanbul, Turkey, obtained blood samples from stable patients with asthma (n=27), COPD (n=35), and ACOS (n=24) who attended 2 centers in the city. Patients included in the study were receiving inhaled steroids and long-acting bronchodilator combination treatment. Blood samples were analyzed, and levels of cysteinyl leukotrienes, PG-D2, prostaglandin E2, interleukin 5, and a disintegrin and metalloprotease domain (ADAM33) were measured. To differentiate between asthma and COPD, the researchers assessed differences between groups and their associations with pulmonary function tests.

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Levels of PG-D2 were higher in both patients with ACOS (120.9±117.2 ng/L) and asthma (119.6±111.7 ng/L) vs patients with COPD (82.6±46.7 ng/L; P =.036 and P =.038, respectively). In patients with ACOS, the researchers observed a negative correlation between values of forced expiratory volume in the first second (FEV1)/forced vital capacity percentage (FVC%) and levels of PG-D2 (P =.021), cysteinyl leukotrienes (P =.008), and ADAM33 (P =.028).

A negative correlation was observed between prostaglandin E2 and FEV1/FVC% (P =.007) in patients with COPD. In addition, through biochemical analysis and spirometric assessment, researchers found positive correlations between interleukin 5 and FVC (P =.047), FVC% (P =.005), FEV1 (P =.002), FEV1% (P =.002), FEF25-75 (P =.010), and FEF25-75% (P =.005). Negative correlations were found between levels of cysteinyl leukotrienes and FEV1 (P =.045) and FEF25-75 (P =.037) values in patients with asthma.

Limitations of the study include the small number of patients, as well as the inclusion of patients from a single geographic area in Turkey.

The study investigators also propose that PG D2 blood levels “may be a sign of systemic inflammation in ACOS.”


Uzan GC, Borekci S, Doventas YE, Koldas M, Gemicioglu B. The relationship between inflammatory markers and spirometric parameters in ACOS, Asthma, and COPD [published online August 12, 2019]. J Asthma. doi:10.1080/02770903.2019.1652644