Q&A: Adults may know their risk for COPD with blood test

Key takeaways:

• Risk for COPD, respiratory-related mortality and a respiratory exacerbation could be found via blood test.
• More studies are needed in addition to these findings before the test can be used in practice.

Adults may soon have an easy way to know whether they face a heightened risk for COPD and death due to a respiratory disease with the creation of a preclinical blood test that assesses 32 proteins, according to a press release.

According to Gabrielle Y. Liu, MD, pulmonologist, assistant professor of medicine at the University of California Davis Medical Center and first author of this study published in American Journal of Respiratory Critical Care Medicine, there are other tests — such as pulmonary function testing, CT scans and genetic testing — that can be used to predict severe respiratory conditions, but each has limitations.

Based on the 32 proteins and their levels, the release said the test presents adults with a score that can be used to find out their risk for COPD, respiratory-related death, an incident respiratory exacerbation and an incident exacerbation that will require hospitalization. Higher scores were found to signal a greater risk for these outcomes.

Healio spoke with Liu to learn more about current testing options, the new blood test and the impact the blood test will have on clinicians and patients once it is ready for use.

Healio: What are the current tests for predicting COPD, pneumonia and other severe respiratory conditions like? What are their limitations?

Liu: A person’s lung function increases until reaching a peak in early adulthood and then gradually declines thereafter. Repeated lung function measurements over an individual’s lifetime can help determine whether they have an abnormal trajectory of lung function. Identifying people who have low peak lung function or rapid decline in lung function later in life can help predict risk for developing COPD and death from respiratory disease. However, obtaining repeated lung function measurements in people without respiratory disease is seldom done in clinical practice. Performing lung function testing is labor-intensive and requires special equipment and special training. Additionally, there remains debate as to whether lung function testing in a healthy general population is useful.

There are also abnormalities on chest CT scans that can help predict who is at risk for developing lung disease in the future. However, obtaining CT scans also requires special equipment and training and are not yet generally recommended to screen for risk for future lung disease in healthy populations.

There are also genetic tests that can help predict who might develop lung disease in the future. However, a limitation of these tests is that they do not present opportunities for modification and intervention.

Healio: How does the new blood test improve on previous methods? Can you spotlight some data supporting these claims?

Liu: Prior methods have picked individual biomarkers to test and study. This study used a proteomics platform that allowed us to examine over a thousand proteins that overlapped with other commonly used proteomics platforms. This broad, discovery-based proteomic sampling has the advantage of finding novel predictors understudied in the context of lung disease.

While prior studies have discovered proteomic signatures that can predict rapid decline in lung function, we were able to show that the susceptibility score was also associated with several relevant health outcomes including incident COPD, respiratory exacerbations, respiratory death and all-cause death.

Healio: What is needed in addition to these findings before this test can be used in practice?

Liu: We are currently designing studies that will allow us to estimate the absolute quantity of these proteins in blood samples so that it can be translated to clinical practice. We also need to test whether these proteins have stable levels on repeated testing. Additionally, there need to be mechanistic studies to test whether the proteins in the susceptibility score represent intervenable pathways of lung-specific pathology.

Healio: What impact will this test have on clinicians and patients once it can be used in practice?

Liu: The proteins identified in this study show promise as biomarkers for impaired respiratory health that can be used to identify individuals at risk for future COPD, hospitalization from respiratory exacerbation and death from respiratory disease. The potential applications of a blood test for early detection of lung disease risk, before irreversible lung damage and marked lung function decline have occurred, could have enormous impact. Mechanistic studies to better understand the roles of these proteins in lung tissue are warranted to determine whether these proteins are potentially druggable targets for the prevention and interception of chronic lung disease.

Similar to controlling an individual’s cholesterol level to lower their risk for developing atherosclerotic cardiovascular disease, there is hope that with further refinement of this blood test, it can eventually be used in the clinical setting to not only predict a person’s risk for developing chronic lung disease but also provide a target for intervention.

For more information:

Gabrielle Y. Liu, MD, can be reached at gabliu@ucdavis.edu.

References:

• Experimental blood test predicts risk for developing COPD, other severe respiratory diseases. https://www.nih.gov/news-events/news-releases/experimental-blood-test-predicts-risk-developing-copd-other-severe-respiratory-diseases. Published Sept. 10, 2024. Accessed Sept. 10, 2024.
• Liu GY, et al. Am J Respir Crit Care Med. 2024;doi:10.1164/rccm.202403-0613OC.