A study presented at the American Thoracic Society’s international conference in San Francisco last week has identified a process initiated in neutrophils, which may lead to worse outcomes for COPD patients.
The finding could help identify patients at higher risk of disease progression and identify a subset of patients who may need treatments other than corticosteroids.
Lead author Dr James Chalmers, from the University of Dundee, Scotland, explained that neutrophil extracellular trap (NET) is a recently identified neutrophil behaviour that is present in COPD patients and may weaken the neutrophils’ ability to eat and kill bacteria. He noted that until now, it was recognised but was not understood why neutrophils were not able to fight infection in COPD patients.
Dr Chalmers and colleagues recruited 141 patients with stable COPD for the study. Sputum and blood were collected at the beginning of the study, during acute COPD exacerbations, and at the end of exacerbations. NETs were measured using a validated enzyme-linked immunosorbent assay targeting specific DNA associated NET/protein complexes. The team found that when NET formation weakens neutrophils’ bacteria-fighting capability, patients experience more frequent chest infections and worse lung function and quality of life.
“This marker may help us identify patients at higher risk of disease progression,” Dr Chalmers said. “And it identifies a subset of patients who may need treatments other than corticosteroids. Our data show that inhaled steroids may even exacerbate NETs, so we need to identify new COPD treatments and discover whether inhibiting NET formation will result in improved clinical outcomes for patients with COPD.”