Indian Researchers Highlight Serum suPAR as Promising Biomarker for Diagnosing and Monitoring COPD

"Patients classified under the Global Initiative for Obstructive Lung Disease (GOLD) stage IV exhibited the highest suPAR levels (6.38 ng/mL), whereas those in stages II and I had lower levels (5.15 ng/mL and 4.17 ng/mL, respectively). These findings suggest that suPAR could be crucial in the COPD diagnosis, monitoring, and management," the researchers reported in Cureus Journal.

The researchers note that COPD is characterized by persistent respiratory symptoms and airflow limitation due to chronic airway inflammation. As the disease progresses, systemic inflammation contributes to worsening lung function and increased morbidity. Identifying reliable biomarkers to assess disease status and predict outcomes remains a key area of research.

Beyond FEV1, the search for a more specific biomarker to predict COPD progression continues to be a challenge. Soluble urokinase-type plasminogen activator receptor (suPAR) expression is elevated in the respiratory epithelial cells of COPD patients, reflecting the underlying inflammatory processes. As COPD severity increases, serum suPAR levels also rise, suggesting its potential as a valuable indicator of disease progression. Therefore, Rekha D, Physiology, Pondicherry Institute of Medical Sciences, Puducherry, India, and colleagues aimed to assess serum suPAR concentrations across different grades of stable COPD patients, providing insights into its role in diagnosis, monitoring, and management.

For this purpose, the researchers recruited 200 stable COPD patients, including 148 males and 52 females, after obtaining informed consent. Blood samples were collected from all participants, and serum suPAR levels were measured to evaluate its potential as a biomarker for disease progression.

Key Findings:

• Serum suPAR levels were higher in COPD patients at GOLD stage IV (6.38 ± 0.05 ng/ml) and GOLD stage III (5.82 ± 0.18 ng/ml) compared to those at GOLD stage II (5.15 ± 0.25 ng/ml) and GOLD stage I (4.17 ± 0.29 ng/ml).
• A one-way ANOVA analysis confirmed that the differences in suPAR levels between the groups were statistically significant (F = 428.83).

The researchers suggest serum suPAR levels can be a valuable biomarker for diagnosing and monitoring COPD. Their findings indicate that suPAR levels rise with increasing disease severity, reflecting low-grade pulmonary inflammation. While pulmonary function tests like spirometry and the six-minute walk test are commonly used, they have limitations due to their subjective and effort-dependent nature. In contrast, serum suPAR, as a quantitative marker, offers a more reliable and objective assessment of disease severity.

"Further prospective cohort studies are needed to validate suPAR role in disease prognosis, which could enhance clinical decision-making, improve patient outcomes, and reduce the overall disease burden," the researchers concluded.

Reference:

D R, Johnson P, Das S, et al. (February 24, 2025) Serum Soluble Urokinase-Type Plasminogen Activator Receptor: A Promising Biomarker for Stable Chronic Obstructive Pulmonary Disease Patients. Cureus 17(2): e79594. doi:10.7759/cureus.79594