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Serum vasoactive intestinal peptide levels influence COPD exacerbation

Increased serum vasoactive intestinal peptide levels appeared associated with acute exacerbation of chronic obstructive pulmonary disease, according to results of a nested cohort study.

Prior research has shown vasoactive intestinal peptide (VIP), the most abundant neuropeptide in the lung, is associated with pulmonary arterial hypertension and hypoxia.

Jyotshna Mandal, PhD, of the Clinic of Pulmonary Medicine and Respiratory Cell Research at University Hospital Basel in Basel, Switzerland, conducted their study to assess vasoactive intestinal peptide levels at exacerbation and at stable COPD.

The analysis included patients with stage II to stage IV disease as classified by the Global Initiative for Chronic Obstructive Lung Disease.

Researchers examined study participants in a stable state and during acute exacerbation of COPD, and they collected dedicated serum at both times. Mandal and colleagues used an enzyme-linked immunosorbent assay to determine serum VIP levels.

The analysis included 120 patients with acute exacerbation COPD and 163 patients with stable COPD. Each group had similar baseline characteristics.

Researchers observed no significant correlation between serum VIP and oxygen saturation at rest or during exercise.

Results showed significantly higher serum VIP levels in the acute exacerbation COPD group (130.25 pg/ml; 95% CI, 112.19-151.83) compared with the stable COPD group (40.07 pg/ml; 95% CI, 37.13-43.96). This association persisted after propensity matching (P < .001).

The optimal serum VIP cutoff value was 56.6 pg/ml, according to analysis of the Youden index.

Mandal and colleagues determined there was a very low probability of acute exacerbation COPD with serum VIP levels less than or equal to 35 pg/ml (sensitivity > 90%), and a very high probability of acute exacerbation COPD if serum VIP levels were at least 88 pg/ml (specificity > 90%).

Researchers determined serum VIP levels are a robust predictor of acute exacerbation COPD (area under the curve, 0.849; 95% CI, 0.77-.89). – by Jeff Craven

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