Prevalence of exacerbation in COPD patients with chronic bronchitis and association with elevated serum inflammatory biomarkers

Background : Chronic bronchitis phenotype is associated with COPD exacerbation. Mechanisms are enhanced local and systemic inflammation. We hypothesized whether chronic bronchitis is associated with exacerbation and increased inflammatory biomarkers. Methods : Stable COPD patients were enrolled in 2103. The presence of chronic bronchitis and exacerbations in the past year were reviewed. Serum hsCRP, fibrinogen and total leukocytes (WBC) were measured. Results: Total 58 COPD patients having mean FEV 1 72.5 % were classified as GOLD A, B, C and D (27.6%, 53.5%, 3.5% and 15.5%). Chronic bronchitis was noted in 43% and exacerbation in the past year was noted in 29.3% of patients. There was no association between chronic bronchitis and COPD exacerbation history (p 0.12). Regarding chronic bronchitic COPD, their WBC, hsCRP and fibrinogen were 6943± 1642 cells /mm 3 , 7.4±10.7 mcg/ml and 318±85.2 mg/dl respectively. There was no difference of inflammatory biomarkers between COPD with and without chronic bronchitis. Furthermore, WBC, hsCRP and fibrinogen of COPD patients with history of exacerbations were 7678± 2226 cells /mm 3 , 10.9±20.3 mcg/ml and 330±91.9 mg/dl respectively. There was no difference of biomarkers between COPD with or without exacerbation history. Additionally, the presence of leukocytosis (WBC> 10,000 cells/mm 3 ), increased hsCRP (>3 mcg/ml), increased fibrinogen (>400 mg/dl) were not associated with exacerbation in the past year. Conclusion : Chronic bronchitis was not associated with history of exacerbations. There was no association between abnormal biomarkers in COPD with exacerbation history and chronic bronchitis.