Homocysteine as prognostic biomarker for increased inflammatory responses in chronic obstructive pulmonary disease

There are studies proving that homocysteine(HC) can be a predictor of COPD itself, as well as studies indicating the liquefying effect of HC on the wall of lysosomes, and as a consequence leading to increased release of proteolytic enzymes from them. The aim of our study was to determine the relationship between COPD severity and elevated HC levels in individuals with severe and extremely severe COPD. The study included 246 patients with COPD, including severe (38.2%) and extremely severe (61.8%), who were treated in the pulmonology department. The level of HC in the blood was determined by enzyme immunoassay. Results. Hyperhomocysteinemia is a common comorbid condition in COPD stages 3-4, 51.1% of patients had a 3-fold increase in the marker level. Also, the HC level changed depending on the COPD phenotype -GOLD,2023 (for A - 29.4±2.95 μmol/l, for B - 32.0±2.23 and for E - 44.0±14.77 μmol/l); from the degree of dyspnea (MRC≦2 - 29.7±5.53 μmol/l and MRC>2 - 32.0±1.89 μmol/l); from an increase in the degree of comorbidity (Charleston Index (CI)≥5 - 37.1±2.83, CI=3-4 - 27.7±2.50 and for CI≦2 - 21.3±1.05 μmol/l). It was found that elevated homocysteine levels were detected in 49% of patients with stage 3 COPD, while in COPD 4 the elevated homocysteine levels were 78%. <bold>Conclusion:</bold> Homocysteine is a marker of increased inflammation in COPD, as indicated by the more frequent high homocysteine levels among patients with very severe COPD, as well as in patients with COPD phenotype E. These observations support the prognostic value of HC in the stratification and management of COPD severity.

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