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dc.contributor.authorAgustí, Alvar
dc.contributor.authorEdwards, Lisa D.
dc.contributor.authorRennard, Stephen I.
dc.contributor.authorMacNee, William
dc.contributor.authorTal-Singer, Ruth
dc.contributor.authorMiller, Bruce E.
dc.contributor.authorVestbo, Jørgen
dc.contributor.authorLomas, David A.
dc.contributor.authorCalverley, Peter M. A.
dc.contributor.authorWouters, Emiel
dc.contributor.authorCrim, Courtney
dc.contributor.authorYates, Julie C.
dc.contributor.authorCoxson, Harvey O.
dc.contributor.authorBakke, Per
dc.contributor.authorMayer, Ruth J.
dc.contributor.authorSilverman, Edwin Kepner
dc.contributor.authorCelli, Bartolome R.
dc.date.accessioned2013-03-13T20:19:15Z
dc.date.issued2012
dc.identifier.citationAgustí, Alvar, Lisa D. Edwards, Stephen I. Rennard, William MacNee, Ruth Tal-Singer, Bruce E. Miller, Jørgen Vestbo, et al. 2012. Persistent systemic inflammation is associated with poor clinical outcomes in COPD: A novel phenotype. PLoS ONE 7(5): e37483.en_US
dc.identifier.issn1932-6203en_US
dc.identifier.urihttp://nrs.harvard.edu/urn-3:HUL.InstRepos:10399870
dc.description.abstractBackground: Because chronic obstructive pulmonary disease (COPD) is a heterogeneous condition, the identification of specific clinical phenotypes is key to developing more effective therapies. To explore if the persistence of systemic inflammation is associated with poor clinical outcomes in COPD we assessed patients recruited to the well-characterized ECLIPSE cohort (NCT00292552). Methods and Findings: Six inflammatory biomarkers in peripheral blood (white blood cells (WBC) count and CRP, IL-6, IL-8, fibrinogen and TNF-\(\alpha\) levels) were quantified in 1,755 COPD patients, 297 smokers with normal spirometry and 202 non-smoker controls that were followed-up for three years. We found that, at baseline, 30% of COPD patients did not show evidence of systemic inflammation whereas 16% had persistent systemic inflammation. Even though pulmonary abnormalities were similar in these two groups, persistently inflamed patients during follow-up had significantly increased all-cause mortality (13% vs. 2%, p<0.001) and exacerbation frequency (1.5 (1.5) vs. 0.9 (1.1) per year, p<0.001) compared to non-inflamed ones. As a descriptive study our results show associations but do not prove causality. Besides this, the inflammatory response is complex and we studied only a limited panel of biomarkers, albeit they are those investigated by the majority of previous studies and are often and easily measured in clinical practice. Conclusions: Overall, these results identify a novel systemic inflammatory COPD phenotype that may be the target of specific research and treatment.en_US
dc.language.isoen_USen_US
dc.publisherPublic Library of Scienceen_US
dc.relation.isversionofdoi:10.1371/journal.pone.0037483en_US
dc.relation.hasversionhttp://www.ncbi.nlm.nih.gov/pmc/articles/PMC3356313/pdf/en_US
dash.licenseLAA
dc.subjectBiologyen_US
dc.subjectAnatomy and Physiologyen_US
dc.subjectImmune Physiologyen_US
dc.subjectCytokinesen_US
dc.subjectImmunologyen_US
dc.subjectImmune Systemen_US
dc.subjectImmunityen_US
dc.subjectInflammationen_US
dc.subjectMedicineen_US
dc.subjectClinical Immunologyen_US
dc.subjectDiagnostic Medicineen_US
dc.subjectPathologyen_US
dc.subjectGeneral Pathologyen_US
dc.subjectBiomarkersen_US
dc.subjectEpidemiologyen_US
dc.subjectBiomarker Epidemiologyen_US
dc.subjectPulmonologyen_US
dc.subjectChronic Obstructive Pulmonary Diseasesen_US
dc.titlePersistent Systemic Inflammation is Associated with Poor Clinical Outcomes in COPD: A Novel Phenotypeen_US
dc.typeJournal Articleen_US
dc.description.versionVersion of Recorden_US
dc.relation.journalPLoS ONEen_US
dash.depositing.authorSilverman, Edwin Kepner
dc.date.available2013-03-13T20:19:15Z
dc.identifier.doi10.1371/journal.pone.0037483*
dash.authorsorderedfalse
dash.contributor.affiliatedCelli, Bartolome
dash.contributor.affiliatedSilverman, Edwin


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