Respiration：HSP27成慢性阻塞性肺病（COPD）检测新标志物

奥地利研究人员一项新研究表明，一种叫做HSP27的蛋白质有可能成为慢性阻塞性肺疾病（COPD）早期检测的新的血液生物标志物。

慢性阻塞性肺疾病(COPD)是一种可以预防可以治疗的疾病，有一些明显的肺外效应，可加重一些患者疾病的严重程度，以不完全可逆的气流受限为特征。气流受限呈进行性加重，多与肺部对有害的颗粒和气体的异常炎症反应有关。慢性阻塞性肺病是第2位造成劳动力丧失的原因，仅次于心脏疾病，并是第4位最常见的死亡原因。吸烟导致约90％的慢性阻塞性肺病案件。

慢性阻塞性肺病的早期发现是治疗成功的关键。随着病情的发展，会出现肺损伤和肺气肿症状。

慢性阻塞性肺病的早期阶段，患者并不会被确诊，因为目前的肺功能测试只检测肺容积的变化，而肺容积的变化发生只出现在疾病的后期阶段。

研究人员认为在肺功能测试检测发现肺容积减少之前，血液中高水平的HSP27能预示慢性阻塞性肺病早期阶段的肺损害。

在这项研究中，研究人员招募了94名健康的男性和女性吸烟者，平均年龄为43岁，自愿接受高解析度CT扫描、肺功能测试，并提供血液样本。

使用特殊的R＆D系统检测试剂盒检测血液样本，研究人员发现HSP27的水平与CT扫描发现的肺损伤具有显著相关性。

研究人员希望有一天肺癌专家在肺部疾病筛查中能用到HSP27标志物。

doi:10.1159/000336557
Increased Serum Levels of HSP27 as a Marker for Incipient Chronic Obstructive Pulmonary Disease in Young Smokers

Ankersmit HJ, Nickl S, Hoeltl E, Toepker M, Lambers C, Mitterbauer A, Kortuem B, Zimmermann M, Moser B, Bekos C, Steinlechner B, Hofbauer H, Klepetko W, Schenk P, Dome B;

Background: Although chronic obstructive pulmonary disease (COPD) is amongst the leading causes of morbidity and mortality, no biomarkers for its early detection are known. We have recently demonstrated that COPD is accompanied by elevated serum heat shock protein (HSP) 27 levels as compared to a control population. Objectives: In an open prospective study, we investigated whether elevated HSP27 levels are associated with the early radiological signs of COPD, i.e. air trapping (AT), emphysema (E) and impaired lung function. Methods: In total, 120 apparently healthy smokers underwent lung function testing and serum sampling. Serum levels of HSP27, phospho-HSP27, CXCR2 chemokines and proteins related to inflammation, tissue remodeling and apoptosis were evaluated by ELISA. Of these 120 subjects, 94 voluntarily underwent a high-resolution computed tomography scan. Results: AT or AT and E were detected in 57.45%. Subjects with AT and E (n = 23) showed significantly higher HSP27 levels than those without any pathology [i.e. nothing abnormal detected (NAD)] (4,618 ± 1,677 vs. 3,282 ± 1,607 pg/ml; p = 0.0081). In a univariate logistic regression model including NAD and AT and E, the area under the curve of HSP27 in the receiver-operating-characteristic curve was 0.724, (0.594–0.854, 95% CI; p = 0.0033). Interestingly, proinflammatory IL-8 was elevated in those subjects with evidence of AT and E compared to those with AT and NAD. Lung function did not correlate with increased HSP27 levels or pathological radiological findings. Conclusions: HSP27 serum levels correlated with the early radiological signs of COPD, whereas lung function did not match with radiological findings or HSP27 serum levels. Serum HSP27 levels may serve as a potential marker to identify the early signs of COPD independent of lung function in young smokers.