Serum Copeptin, Cortisol and C-Reactive Protein Levels in Heavy Smokers With and Without Acute Exacerbated Chronic Obstructive Pulmonary Disease

Chronic Obstructive Pulmonary Disease (COPD) is a heterogeneous disease characterized by episodes of acute exacerbations which are caused mainly by infections of the tracheobronchial tree or by inhalation of toxic gases. Tobacco smoking is the most common cause of COPD, accounting for 80-90% of COPD deaths, but not all smokers develop COPD. Copeptin is a stress and inflammatory marker recently studied in patients with Acute Exacerbated Chronic Obstructive Pulmonary Disease (AECOPD). Cortisol is the classical stress hormone that proportionate to degree of stress. C-reactive protein (CRP) is an acute-phase reactant that is commonly used as a biomarker of systemic inflammation in patients with AECOPD.Aim of the Study: Evaluate the value of serum Copeptin, Cortisol and C-Reactive Protein levels in heavy smokers with and without AECOPD.Patients and Methods: We studied forty five (45) participants, 15 of them were heavy smokers with AECOPD (group 1), their mean ages ±SD (34.80±4.16), another 15 were heavy smokers without AECOPD (group 2), their ages ±SD (36.47± 3.74) and 15 healthy non smoker volunteers as control (group 3), their ages ±SD (35.33±3.75). Blood samples were taken for measuring serum Copeptin, Cortisol and CRP levels as well other routine investigations and pulmonary function test were done for all groups.Results: Significant higher serum copeptin level in group 1 and group 2 as compared to group 3 p 0.05, but non significant difference was found between group 1 and group 2 p 0.05. Non significant difference in either serum Cortisol or CRP levels was found between group 1 as compared to group 3 and between group 2 as compared to group 3, also between group 1 as compared to group 2 p 0.05. Regarding pulmonary function test significant difference in Forced Expiratory Volume Predict (FEV 1% PR), Forced Vital Capacity Predict (FVC% PR), and FEV1/FVC respectively in group 1 as compared to group 2 and when compared to group 3, also between group 2 as compared to group 3 p 0.01.Conclusion: Heavy smokers remain at risk of persistent inflammation and oxidative stress irrespective of COPD. AECOPD is an acute illness that enter the patient in stress and inflammation. Copeptin is an interest new stress and inflammatory biomarker in AECOPD, it more subtly mirrors the individual stress level more than cortisol in heavy smokers with AECOPD. CRP commonly used as a biomarker of systemic inflammation in AECOPD.