Evaluation of Systemic Inflammatory Markers in COPD Patients During Stable and Exacerbation Phases

• SHAHZAD SHOUKAT

  Assistant Professor of Cardiology, Cardiology Department, Punjab institute of Cardiology, Lahore

  Author

• BILAL RAFIQUE MALIK

  Associate Professor of Medicine, South Medical Ward, Mayo Hospital Lahore

  Author

• SHAHID IQBAL

  Consultant Cardiologist, Cardiology Department, Punjab Institute of Cardiology, Jail Road, Lahore

  Author

Background: Chronic Obstructive Pulmonary Disease (COPD) is a progressive inflammatory disorder characterized by irreversible airflow limitation and recurrent exacerbations that accelerate morbidity and mortality. Systemic inflammation plays a crucial role in disease progression, yet variations in inflammatory marker levels during stable and exacerbation phases remain under-evaluated in regional populations.

Objective: To assess and compare systemic inflammatory markers—C-reactive protein (CRP), interleukin-6 (IL-6), and tumor necrosis factor-alpha (TNF-α)—in COPD patients during stable and exacerbation phases and determine their clinical significance.

Methods: This cross-sectional study was conducted across tertiary care centers in Punjab, Pakistan, from January 2024 to December 2024. A total of 100 spirometry-confirmed COPD patients were enrolled, equally divided into stable and exacerbation groups. Venous blood samples were collected for quantitative estimation of CRP, IL-6, and TNF-α using high-sensitivity immunoturbidimetric and ELISA assays. Data were analyzed using SPSS v26, and p < 0.05 was considered statistically significant.

Results: Mean serum CRP, IL-6, and TNF-α levels were significantly higher during exacerbation (27.9 ± 7.8 mg/L, 12.2 ± 3.5 pg/mL, and 18.7 ± 4.9 pg/mL, respectively) compared with the stable phase (8.6 ± 3.4 mg/L, 4.1 ± 1.6 pg/mL, and 9.4 ± 3.1 pg/mL; p < 0.001). A strong positive correlation was observed between IL-6 and TNF-α (r = 0.79) during exacerbations, indicating synergistic cytokine activation.

Conclusion: Systemic inflammation markedly intensifies during COPD exacerbations, with CRP, IL-6, and TNF-α serving as reliable biomarkers for disease monitoring. Regular assessment of these markers may enhance early detection, therapeutic optimization, and prevention of recurrent exacerbations.

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