Title Biomarkeri u kroničnoj opstruktivnoj bolesti pluća Title (english) Biomarkers in chronic obstructive pulmonary disease Author Eva Perak Mentor Marija Gomerčić Palčić (mentor)Committee member Sanja Popović-Grle (predsjednik povjerenstva)Committee member Marko Jakopović (član povjerenstva)Committee member Marija Gomerčić Palčić (član povjerenstva)Granter University of Zagreb Defense date and country 2023-09-19, Croatia Scientific / art field, BIOMEDICINE AND HEALTHCARE Abstract Kronična opstruktivna bolest pluća (KOPB) jedan je od vodećih javnozdravstvenih problema u svijetu. Jedan od razloga za to je velika heterogenost patogenetskih mehanizama i kliničkih prezentacija bolesti, zbog čega se jedna terapijska strategija ne može uspješno primijeniti na sve bolesnike, već je potreban personalizirani pristup. Stoga je znanost u potrazi za biomarkerima koji bi mogli pomoći identificirati podskupine bolesnika sa zajedničkim karakteristikama i tako povećati uspješnost postojećih terapijskih intervencija, kao i ubrzati razvoj novih. Postoji pregršt znanstvenih radova koji istražuju povezanost različitih biomarkera s kliničkim i terapijskim ishodima. Jedan od najznačajnijih biomarkera jest broj eozinofila u perifernoj krvi. Veći broj eozinofila predviđa bolji odgovor na inhalacijske kortikosteroide te je stoga uvršten u smjernice Globalne inicijative za kroničnu opstruktivnu bolest pluća (GOLD) kao kriterij za započinjanje te terapije. Neka istraživanja ukazuju na povezanost više razine eozinofila u krvi s većim rizikom od egzacerbacija, no dokazi za to su još uvijek nejasni. Osim eozinofila, u krvi se mogu mjeriti koncentracije cijelog niza molekula koje bi mogle poslužiti kao biomarkeri. Najveći potencijal pruža fibrinogen koji je odobren za korištenje u istraživanjima kao biomarker povećanog rizika od egzacerbacije i smrti. Od fizioloških biomarkera, spirometrijski parametri poput forsiranog ekspiratornog volumena u prvoj sekundi (FEV1) i forsiranog vitalnog kapaciteta (FVC) već se koriste kao dijagnostički biomarkeri, dok je difuzijski kapacitet pluća za ugljikov monoksid pokazao čak i bolju povezanost s nekim kliničkim ishodima. Od slikovnih metoda najveću ulogu u KOPB-u ima kompjuterizirana tomografija (CT) kojom se mogu detektirati emfizem i kronični bronhitis, kao i eventualni komorbiditeti. Brojne molekule, produkti upale u plućima, mogu se detektirati u uzorcima iskašljaja, bronhoalveolarnog lavata, u izdahnutom zraku te kondenzatu izdahnutog zraka. Istražena je i povezanost ekstracelularnih vezikula, genetičkih biomarkera i molekularnih pokazatelja plućne starosti s ishodima u KOPB-u. Klinička primjena ovih biomarkera vjerojatno će počivati na njihovoj kombinaciji, a potrebna su daljnja istraživanja prije nego što ona bude moguća.
Abstract (english) Chronic obstructive pulmonary disease (COPD) is one of the main public health problems in the world. One of the reasons for that is a vast heterogeneity of pathogenetic mechanisms and clinical manifestations, because of which one therapeutic strategy cannot be successfully applied to all patients. Instead, a personalized approach is needed. That’s why the scientific community is looking for biomarkers that could help identify subgroups of patients with common characteristics and thus increase the efficacy of current therapeutic interventions, as well as accelerate the development of new ones. There is a great number of research papers that explore the association of different biomarkers with clinical and therapeutic outcomes. One of the most significant biomarkers is the blood eosinophil count. Higher eosinophil count predicts a better response to inhaled corticosteroids and is therefore included in the Global Initiative for Chronic Obstructive Lung Disease (GOLD) guidelines as a criterion for initiating that treatment. Some articles indicate an association of higher blood eosinophil counts with a higher exacerbation risk, but the evidence is still insufficient. Beside eosinophils, concentrations of various molecules which could serve as biomarkers can be measured in the blood. Fibrinogen provides the greatest potential and is approved for use in research as a biomarker of increased risk of exacerbation and death. Among physiological biomarkers, spirometry parameters such as forced expiratory volume in the first second (FEV1) and forced vital capacity (FVC) are already being used as diagnostic biomarkers, and diffusing capacity of the lungs for carbon monoxide demonstrated even greater association with some clinical outcomes. Among imaging methods in COPD, computed tomography (CT) has the biggest role. It can detect emphysema and chronic bronchitis, as well as potential comorbidities. Various molecules, products of lung inflammation, can be detected in samples of sputum, bronchoalveolar lavage, exhaled breath, and exhaled breath condensate. Associations of extracellular vesicles, genetic biomarkers and molecular signs of lung ageing with COPD outcomes have also been investigated. Clinical implementation of these biomarkers will probably rely on their combination, but further research is needed before it becomes possible.
Keywords
kronična opstruktivna bolest pluća
biomarkeri
personalizirana medicina
Keywords (english)
chronic obstructive pulmonary disease
biomarkers
personalized medicine
Language croatian URN:NBN urn:nbn:hr:105:458563 Study programme Title: Medicine Type of resource Text File origin Born digital Access conditions Open access Terms of use Created on 2023-10-27 11:46:36
