20.500.12556/DiRROS-13692 Fractional heat shock protein 27 urine excretion as a short-term predictor in acute exacerbation of chronic obstructive pulmonary disease Background: Chronic obstructive pulmonary disease (COPD) is a major cause of morbidity and mortality and is characterized by episodes of acute exacerbations. Finding a systemic biomarker that reliably predicts outcome after an acute exacerbation remains a major challenge. Heat shock protein 27 (HSP27) has been previously studied in COPD, however, urine excretion trajectory and prognostic value after an exacerbation is unknown. Methods: In this retrospective post hoc analysis of a prospective study that included 253 COPD patients who were hospitalized for acute exacerbation, 207 patients were analyzed. Urine and serum were sampled at admission, discharge, and 180 days after discharge; urine excretion trajectory was analyzed and correlated with clinicopathological and survival data. Results: HSP27 urine excretion increased after an exacerbation episode [1.8% admission, 1.8% discharge, 2.3% 180 days after discharge (P=0.091)]. In severely ill patients (GOLD IV) this course was even more distinct [1.6% admission, 2.1% discharge, 2.8% 180 days after discharge (P=0.007)]. Furthermore, fractional HSP27 urine excretion at discharge was increased in GOLD IV patients (P=0.031). In Kaplan-Meier and univariable Cox proportional hazard models patients with HSP27 urine excretion below 0.845% showed significantly worse survival at 30, 90 and 180 days after discharge. In a multivariable Cox proportional hazard model including established COPD outcome parameters fractional HSP27 urine excretion remained a significant predictor of survival at 30 and 90 days after discharge. Comparing this model to our already published model that includes HSP27 serum concentration we could show that fractional HSP27 urine excretion performs better in short-term survival. Conclusions: Our findings provide novel information about fractional HSP27 urine excretion trajectory in acute exacerbation of COPD. Fractional HSP27 urine excretion may be significantly reduced during an episode of acute exacerbation in COPD patients and may be used as a predictor of short-term all-cause mortality. biomarkers heat-shock proteins chronic obstructive pulmonary disease urine heat shock protein 27 biološki označevalci stresni proteini kronična pljučna obstruktivna bolezen urin stresni protein 27 true false true AME Publishing Company Angleški jezik Ni določen © Annals of Translational Medicine Neznano 2021-01-25 14:26:24 2021-01-25 14:26:25 2022-08-19 03:36:06 0000-00-00 00:00:00 2020 0 Kitajska 0 Nasl. z nasl. zaslona; Soavtorji iz Slovenije: Mitja Lainscak, Robert Marčun, Mitja Košnik, Matjaž Fležar, Aleš Rozman, Peter Korošec; Opis vira z dne 18. 1. 2021; str. 1-13 iss. Vol. 9 2020 0000-00-00 PostprintKoncna VTisku NiDoloceno 0000-00-00 0000-00-00 0000-00-00 616.2 2305-5847 10.21037/atm-20-3683 47394051 33574617 RAZ_Traxler_Denise_i2020.pdf RAZ_Traxler_Denise_i2020.pdf 1 53BDEC308315952F842DBFB7E830BBDC 637916c364e49a59f57412d5912b62aec685174511d2c9060593b4acc2072651 84595be6-17b6-11ed-b6b8-001a4af901a5 https://dirros.openscience.si/Dokument.php?lang=slv&id=17147 https://atm.amegroups.com/article/view/59820/pdf 1 https://dirros.openscience.si/Dokument.php?lang=slv&id=16720 Univerzitetna klinika za pljučne bolezni in alergijo Golnik 0 0 0