Elevated plasma level of Pentraxin 3 is associated with emphysema and mortality in smokers

Thorax. 2021 Apr;76(4):335-342. doi: 10.1136/thoraxjnl-2020-215356. Epub 2021 Jan 21.

Abstract

Background: Pentraxin 3 (PTX3) influences innate immunity and inflammation, host defence, the complement cascade and angiogenesis. PTX3 expression in lung and blood of subjects with tobacco exposure, and its potential relationship with disease pattern and clinical outcome are poorly understood.

Methods: Using independent platforms and cohorts, we identified associations of PTX3 gene expression in lung tissue and plasma from current and former tobacco smokers (with and without chronic obstructive pulmonary disease, COPD) to disease phenotypes including quantitative CT determined emphysema, lung function, symptoms and survival. Two putative regulatory variants of the PTX3 gene were examined for association with COPD manifestations. The relationship between plasma PTX3 and hyaluronic acid levels was further examined.

Results: PTX3 gene expression in lung tissue was directly correlated with emphysema severity (p<0.0001). Circulating levels of PTX3 were inversely correlated with FEV1 (p=0.006), and positively associated with emphysema severity (p=0.004) and mortality (p=0.008). Two PTX3 gene regulatory variants were associated with a lower risk for emphysema and expiratory airflow obstruction, and plasma levels of PTX3 and hyaluronic acid were related.

Conclusions: These data show strong and overlapping associations of lung and blood PTX3 levels, and PTX3 regulatory gene variants, with the severity of airflow obstruction, emphysema and mortality among smokers. These findings have potential implications regarding the pathogenesis of smoking-related lung diseases and warrant further exploration for the use of PTX3 as a predictive biomarker.

Keywords: COPD ÀÜ mechanisms; emphysema.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Biomarkers / metabolism
  • C-Reactive Protein / genetics
  • C-Reactive Protein / metabolism*
  • Female
  • Gene Expression
  • Humans
  • Hyaluronic Acid / metabolism
  • Male
  • Middle Aged
  • Phenotype
  • Pulmonary Disease, Chronic Obstructive / metabolism
  • Pulmonary Emphysema / metabolism*
  • Pulmonary Emphysema / mortality*
  • Pulmonary Emphysema / physiopathology
  • Respiratory Function Tests
  • Serum Amyloid P-Component / genetics
  • Serum Amyloid P-Component / metabolism*
  • Smokers*
  • Survival Rate
  • Tomography, X-Ray Computed

Substances

  • Biomarkers
  • Serum Amyloid P-Component
  • PTX3 protein
  • Hyaluronic Acid
  • C-Reactive Protein