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.”

Reference

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