RT Journal Article
SR Electronic
T1 Multi-level differential network analysis of COPD exacerbations
JF European Respiratory Journal
JO Eur Respir J
FD European Respiratory Society
SP 1700075
DO 10.1183/13993003.00075-2017
VO 50
IS 3
A1 Guillaume Noell
A1 Borja G. Cosío
A1 Rosa Faner
A1 Eduard Monsó
A1 German Peces-Barba
A1 Alfredo de Diego
A1 Cristobal Esteban
A1 Joaquim Gea
A1 Robert Rodriguez-Roisin
A1 Marian Garcia-Nuñez
A1 Francisco Pozo-Rodriguez
A1 Susana G. Kalko
A1 Alvar Agustí
YR 2017
UL http://erj.ersjournals.com/content/50/3/1700075.abstract
AB Patients with chronic obstructive pulmonary disease (COPD) often suffer episodes of exacerbation (ECOPD) that impact negatively the course of their disease. ECOPD are heterogeneous events of unclear pathobiology and non-specific diagnosis. Network analysis is a novel research approach that can help unravelling complex biological systems. We hypothesised that the comparison of multi-level (i.e., clinical, physiological, biological, imaging and microbiological) correlation networks determined during ECOPD and convalescence can yield novel patho-biologic information.In this proof-of-concept study we included 86 patients hospitalised because of ECOPD in a multicentre study in Spain. Patients were extensively characterised both during the first 72 h of hospitalisation and during clinical stability, at least 3 months after hospital discharge.We found that 1) episodes of ECOPD are characterised by disruption of the network correlation observed during convalescence; and 2) a panel of biomarkers that include increased levels of dyspnoea, circulating neutrophils and C-reactive protein (CRP) has a high predictive value for ECOPD diagnosis (AUC 0.97).We conclude that ECOPD 1) are characterised by disruption of network homeokinesis that exists during convalescence; and 2) can be identified objectively by using a panel of three biomarkers (dyspnoea, circulating neutrophils and CRP levels) frequently determined in clinical practice.This is the first study to investigate COPD exacerbations using multi-level differential network analysis http://ow.ly/uYlW30eMpwR