Analysis of sputum markers in the evaluation of lung inflammation and functional impairment in symptomatic smokers and COPD patients

Gregorino Paone, Vittoria Conti, Annarita Vestri, Alvaro Leone, Giovanni Puglisi, Fulvio Benassi, Giuseppe Brunetti, Giovanni Schmid, Ilio Cammarella, Claudio Terzano

Research output: Contribution to journalArticlepeer-review


The pivotal role of neutrophils and macrophages in smoking-related lung inflammation and COPD development is well-established. We aimed to assess whether sputum concentrations of Human Neutrophil Peptides (HNP), Neutrophil Elastase (NE), Interleukin-8 (IL-8), and Metalloproteinase-9 (MMP-9), major products of neutrophils and macrophages, could be used to trace airway inflammation and progression towards pulmonary functional impairment characteristic of COPD. Forty-two symptomatic smokers and 42 COPD patients underwent pulmonary function tests; sputum samples were collected at enrolment, and 6 months after smoking cessation. HNP, NE, IL-8, MMP-9 levels were increased in individuals with COPD (p <0.0001). HNP and NE concentrations were higher in patients with severe airways obstruction, as compared to patients with mild-to-moderate COPD (p =0.002). A negative correlation was observed between FEV 1 and HNP, NE and IL-8 levels (p <0.01), between FEV 1FVC and HNP, NE and IL-8 levels (p<0.01), and between NE enrolment levels and FEV 1 decline after 2 years (p =0.04). ROC analysis, to discriminate symptomatic smokers and COPD patients, showed the following AUCs: for HNP 0.92; for NE 0.81; for IL-8 0.89; for MMP-9 0.81; for HNP, IL-8 and MMP-9 considered together 0.981. The data suggest that the measurement of sputum markers may have an important role in clinical practice for monitoring COPD.

Original languageEnglish
Pages (from-to)91-100
Number of pages10
JournalDisease Markers
Issue number2
Publication statusPublished - 2011


  • Airway inflammation
  • Chronic obstructive pulmonary disease
  • human neutrophil peptides
  • interleukin-8
  • likelihood ratio
  • metalloproteinase-9
  • neutrophil elastase
  • receiver operating characteristic analysis
  • smoking
  • sputum

ASJC Scopus subject areas

  • Biochemistry, medical
  • Clinical Biochemistry
  • Molecular Biology
  • Genetics


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