Gamma globulin fraction of the proteinogram and chronic obstructive pulmonary disease exacerbations

Abstract

Objectives: To evaluate the levels of the serum gamma globulin fraction in proteinograms as a biomarker to assess the severity, and to predict the mortality and new exacerbations in patients admitted for an exacerbation of a COPD.

Patients and methods: The VIRAE study was carried out on a cohort of patients hospitalized for an exacerbation of probable infectious origin of COPD over a period of 2 years. The levels of the serum gamma globulin fraction were analyzed in the proteinogram of 120 patients. The main clinical indicators of severity were also evaluated. Key features were compared in 2 groups (gamma fraction in the proteinogram greater or less than 6.6g/dl).

Results: The levels of the serum gamma fraction in the proteinogram correlated with the FEV₁ (P=.009), the CRP (P=.04), and the number of readmissions after 6 months of hospitalization (P=.04). We observed a good association with the GOLD scale, the BODE index and the mMRC dyspnea scale; and also with treatment with oral corticoids and home oxygen therapy. We did not find it to be a good predictor of mortality, despite observing increased mortality rates one year after hospital admission in patients with low levels of the factor.

Conclusions: The levels of the gamma globulin fraction in proteinograms has a good correlation with the FEV₁. In addition, they are associated with a greater severity of patients with COPD. This simple biomarker may be useful in identifying high-risk patients.

Keywords: Acute exacerbation; Biomarcador; Biomarker; Chronic obstructive pulmonary disease; Enfermedad pulmonar obstructiva crónica; Etiología infecciosa; Exacerbación aguda; Gamma globulins; Gammaglobulinas; Infectious etiology; Mortalidad; Mortality; Prognostic; Pronóstico.