Plasma Cathelicidin is Independently Associated with Reduced Lung Function in COPD: Analysis of the Subpopulations and Intermediate Outcome Measures in COPD Study Cohort.
Burkes. Robert M RM; Ceppe. Agathe S AS; Couper. David J DJ; Comellas. Alejandro P AP; Wells. J Michael JM; Peters. Stephen P SP; Criner. Gerard J GJ; Kanner. Richard E RE; Paine. Robert R; Christenson. Stephanie A SA; Cooper. Christopher B CB; Barjaktarevic. Igor Z IZ; Krishnan. Jerry A JA; Labaki. Wassim W WW; Han. MeiLan K MK; Curtis. Jeffrey L JL; Hansel. Nadia N NN; Wise. Robert A RA; Drummond. M Bradley MB
Key Findings
- People with plasma LL‑37 below 50 ng/mL had about 3.5% lower predicted FEV1 compared to those with higher levels
- Each 10 ng/mL drop in LL‑37 was linked to a 0.65% drop in predicted FEV1
- Low LL‑37 was more common in women, Black individuals, and those with lower BMI, but it did not predict future lung function loss or COPD exacerbations
Practical Outcomes
- Measuring LL‑37 could help spot COPD patients who already have reduced lung capacity, but there’s no evidence yet that changing LL‑37 levels will improve outcomes. For biohackers, the finding suggests LL‑37 is a potential biomarker, yet without proven ways to safely raise it, it remains more of a diagnostic hint than a direct intervention.
Summary
A study of people with COPD found that those with low levels of the natural antimicrobial peptide LL‑37 in their blood tended to have worse lung function at the time of testing, but low LL‑37 didn’t predict faster decline or more flare‑ups over time.
Abstract
The antimicrobial peptide cathelicidin, also known in humans as LL-37, is a defensin secreted by immune and airway epithelial cells. Deficiencies in this peptide may contribute to adverse pulmonary outcomes in chronic obstructive pulmonary disease (COPD). Using clinical and biological samples from the SubPopulations and InteRmediate Outcome Measures In COPD Study (SPIROMICS), we assessed the associations of plasma cathelicidin levels with cross-sectional and longitudinal COPD outcomes. A total of 1609 SPIROMICS participants with COPD and available plasma samples were analyzed. Cathelicidin was modeled dichotomously (lowest quartile [< 50 ng/ml] versus highest 75% [≥ 50 ng/ml]) and continuously per 10 ng/ml. Fixed-effect multilevel regression analyses were used to assess associations between cathelicidin and cross-sectional as well as longitudinal lung function. The associations between cathelicidin and participant-reported retrospective and prospective COPD exacerbations were assessed via logistic regression. Cathelicidin < 50 ng/ml (N=383) was associated with female sex, black race, and lower body mass index (BMI).At baseline,cathelicidin < 50 ng/ml was independently associated with 3.55% lower % predicted forced expiratory volume in 1 second (FEV<sub>1</sub>)(95% confidence interval [CI] -6.22% to -0.88% predicted; <i>p</i>=0.01), while every 10 ng/ml lower cathelicidin was independently associated with 0.65% lower % predicted FEV<sub>1</sub> (95% CI -1.01% to -0.28% predicted; <i>p</i>< 0.001). No independent associations with longitudinal lung function decline or participant-reported COPD exacerbations were observed. Reduced cathelicidin is associated with lower lung function at baseline. Plasma cathelicidin may potentially identify COPD patients at increased risk for more severe lung disease.
Study Information
pubmed
2020
2020-10-01T00:00:00.000Z
10.15326/jcopdf.7.4.2020.0142
10