الفهرس 
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Abstract
According to definitions, COPD is a common, treatable, and preventable condition marked by recurrent respiratory symptoms and airflow limitation brought on by abnormalities in the airways and/or alveolar abnormalities, which are typically brought on by significant exposure to noxious particles or gases and influenced by host factors like abnormal lung development. There is a growing research interest to define the pathophysiological features of biomarkers and their role in the diagnosis of COPD.
Proteinase 3 (PR3), alternately noted to as azurophil granule protein-7, p29b or myeloblastin, is an extremely plentiful neutrophilic protein, which is genetically transcribed in monocytic progenitor cells and primitive myeloid progenitor cells, and present in cells of monocyte and granulocyte linage, especially neutrophils but involving basophils and mast cells.
PR3 is likely to have more important role in COPD pathophysiology. COPD pathophysiology is regarded to reflect an inequality between lung proteinases and anti-proteinases.
The purpose of this study was to study and evaluate the level of serum proteinase-3 as a biomarker in COPD and its relation to clinical, functional and radiological manifestations.
To achieve this aim, the present study was conducted on 15 control subjects and 30 patients with COPD. Patients were identified using GOLD guidelines. Full medical history and routine physical examination were performed to all patients. The following investigations were carried out:
1. Anthropometric measurements including: weight and height. BMI (weight in Kg /height in m2) was calculated.
2. Assessment of dyspnea grade using the modified medical research council (mMRC) dyspnea scale.
3. Six Minute Walk Test (6MWT):
The six-minute walk distance (6MWD) for all the cases and control subjects was measured. The percent predicted 6MWD was computed according to the following reference equations:
For men, 6MWD = (7.57 x height cm) – (5.02 x age) – (1.76 x weight kg) – 309m.
For woman, 6MWD = (2.11 x height cm) – (2.29 x weight kg) – (5.78 x age) + 667m.
4. Measurement of serum proteinase-3:
Venous blood samples were collected for determination of the serum level of proteinase-3 (PR-3) using a commercially available enzyme linked immunosorbent assay (ELISA) kit.
5. Chest High Resolution Computerised Tomography (HRCT) was accomplished to all cases utilizing a 16-slice spiral CT scanner to determine airway wall dimensions and the extent of emphysema.
6. Data were calculated and analysed using SPSS.
Our results revealed the following:
• 6 MWT actual distance and 6MWT % predicted were significantly decreased in the COPD cases in comparison with controls.
• Serum level of proteinase 3 (ng / ml) was statistically significantly higher in the COPD patients as compared with controls.
• Significant positive correlations were found between serum level of proteinase 3 and other severity parameters in COPD patients, including: smoking index, mMRC dyspnea scale, emphysema score and emphysema grading.
• A significant negative correlation was found between 6 MWT distance and serum level of proteinase 3.
• Serum level of proteinase 3 (ng/ml) had no significant correlations with body mass index (Kg/m2), any airway wall thickness parameters or 6 MWT % predicted distance in COPD patients.
• HRCT measurements demonstrated that the emphysema score was significantly negatively correlated with the 6 MWT actual distance and 6 MWT % predicted distance, while smoking index (pack/year) and mMRC dyspnea scale were significantly positively correlated with the emphysema score.
• Emphysema grading was significantly negatively correlated with the 6 MWT actual distance (m) and 6 MWT% predicted distance. In addition, smoking index (pack/year) and mMRC dyspnea scale were significantly positively correlated with emphysema grading.
• 6 MWT actual distance was significantly negatively correlated with the smoking index (pack/ year) and mMRC dyspnea scale.