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Table 2 Assessment of EBC biomarkers at ECOPD

From: Pulmonary biomarkers in COPD exacerbations: a systematic review

Biomarker Ref. ECOPD onset Course: Comment
   Comparisons After ECOPD  
    onset  
AAT [30] ECOPD > COPD, controls   
ATP [17] ↔: ECOPD, smokers, non-smokers Time points: admission, discharge
cysLTs [29]   ICS with or without systemic GCS. Time points: onset, Visit 1 (D2-4), Visit 2 (2-4D post antibiotics), Visit 3 (21-28D post antibiotics). ↓ by visit 2.
H 2 O 2 [27] ECOPD > controls (smokers and non-smokers) GCS. ↓ by D7
  [28]   GCS. ↓ by D3-4
  [29]   ICS with or without GCS. Time points: onset, Visit 1 (D2-4), Visit 2 (2-4D post antibiotics), Visit 3 (21-28D post antibiotics). ↓ by visit 2.
IL-1β [24] ECOPD > controls, smokers, stable COPD   
IL-6 [31] ECOPD > controls No GCS. ↓ by 2 W. Reduced after 6 M of mucolytic therapy
  [24] ECOPD > controls, stable COPD, ECOPD In GW > smokers   ICU or GW patients
IL-8 [24] ECOPD > controls, smokers, stable COPD   ECOPD patients hospitalized either in the ICU or in GW
  [32]    Undetectable in most subjects
  [25] ECOPD > nonsmokers, asymptomatic smokers, symptomatic smokers   Detected in 14% of healthy smokers, 20% of non-symptomatic smokers, 43% of symptomatic smokers
  [33] ECOPD > asthma exacerbations, ↔: ECOPD, controls   GCS.
IL-10 [24] ECOPD > controls, smokers, stable COPD   ICU or GW patients
IL-12p70 [24] ECOPD > controls, smokers, stable COPD   ICU or GW patients
IL-17 [33] ↔: ECOPD, asthma exacerbations, controls   GCS.
IFN-γ [23] ECOPD < controls (p value N/R)   Improved detection when an albumin-coated collector was used
8-isoprostane [31] ECOPD > controls No GCS. ↓ by 2 W. Reduced after 6 M of mucolytic therapy
[34] ECOPD > controls No GCS. ↓ by 2 W. Reduced further within 2 M
[25] ECOPD > nonsmokers, asymptomatic smokers, Symptomatic smokers   
  [29]   ICS with or without systemic GCS. Time points: onset, Visit 1 (D2-4), Visit 2 (2-4D post antibiotics), Visit 3 (21-28D post antibiotics). ↓ by visit 2.
LTB4 [34] ECOPD > controls No GCS. ↓ by 2 W. Reduced further within 2 M
  [32] ↔: ECOPD, controls, stable COPD GCS. Time points: D5,14,30,60
  [29]   ICS with or without systemic GCS. Time points: onset, Visit 1 (D2-4), Visit 2 (2-4D post antibiotics), Visit 3 (21-28D post antibiotics). ↓ by visit 3.
MPO [23] ECOPD > controls   For samples collected with an albumin-coated apparatus
Ph [13] ↔: ECOPD, controls Time points: admission, discharge. CO2 standardization method
PGE2 [29]   ICS with or without systemic GCS. Time points: onset, Visit 1 (D2-4), Visit 2 (2-4D post antibiotics), Visit 3 (21-28D post antibiotics).
Protein [24] ↔: ECOPD, controls, smokers, stable COPD   
  [35]    
SLPI [23] ECOPD > controls   For samples collected with an albumin-coated apparatus
TNF-α [24] ECOPD > controls, smokers, stable COPD   ICU or GW patients
  [32] ↔: ECOPD on D5, controls, stable COPD GCS. Time points: D5, 14, 30, 60. Lowest levels on D5, D14 > D5 and D14 = D30 = D60
  [33] ↔: ECOPD, controls   GCS.
  1. The column concerning the course of EBC biomarkers refers to longitudinal studies (paired samples) and the column concerning comparisons at ECOPD onset refers to cross-sectional studies (unpaired samples). No study has assessed the course of EBC biomarkers from baseline towards ECOPD onset.
  2. Abbreviations: AAT alpha 1 antitrypsin, ATP adenosine triphosphate, CysLTs cysteinyl-leukotrienes, D day after ECOPD onset, GCS administration of systemic glucocorticosteroids, GW general ward, H 2 O 2 hydrogen peroxide, ICS inhaled corticosteroids, ICU Intensive care unit, IL interleukin, IFN-γ interferon gamma, LTB4 leukotriene B4, M months after ECOPD onset, min: minimum, MPO myeloperoxidase, N/R not reported, PGE2 prostaglandin E2, SLPI secretory leukocyte protease inhibitor, TNF-α tumor necrosis factor alpha, W weeks after ECOPD onset.
  3. Symbols: ↔: no difference, ↑: increase, ↓: decrease.
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