Evidence map›Paper›PMID 41851771›Full record

ArticleRespiratory research2026

Blood cell ratio biomarkers of systemic inflammation in chronic obstructive pulmonary disease.

Kaman So, Aabida Saferali, Jeong H Yun, Min Hyung Ryu, Enrico Schiavi, Peter J Castaldi, Lisa Ruvuna, Russell P Bowler, Jeffrey L Curtis, Craig P Hersh

Abstract read
In one paragraph

Article in Respiratory research, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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0citing papers in PubMed
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1 · What the graph read from it

What it found

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2 · The registry

The trial behind it

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3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

10 authors.

Kaman SoChanning Division of Network Medicine, Brigham and Women's Hospital, 181 Longwood Avenue, Boston, MA, 02115, USA.
Aabida SaferaliChanning Division of Network Medicine, Brigham and Women's Hospital, 181 Longwood Avenue, Boston, MA, 02115, USA.
Jeong H YunChanning Division of Network Medicine, Brigham and Women's Hospital, 181 Longwood Avenue, Boston, MA, 02115, USA.ORCID http://orcid.org/0000-0002-4361-8295
Min Hyung RyuDivision of Respiratory Medicine, University of British Columbia, Vancouver, BC, Canada.ORCID http://orcid.org/0000-0003-3071-7363
Enrico SchiaviSapienza University of Rome, Rome, Italy.ORCID http://orcid.org/0009-0003-3954-8620
Peter J CastaldiChanning Division of Network Medicine, Brigham and Women's Hospital, 181 Longwood Avenue, Boston, MA, 02115, USA.
Lisa RuvunaDepartment of Systems Biology and Genome Sciences, Cleveland Clinic, Cleveland, OH, USA.ORCID http://orcid.org/0000-0002-3800-511X
Russell P BowlerDepartment of Systems Biology and Genome Sciences, Cleveland Clinic, Cleveland, OH, USA.ORCID http://orcid.org/0000-0003-4651-363X
Jeffrey L CurtisDivision of Pulmonary and Critical Care Medicine, University of Michigan, Ann Arbor, MI, USA.ORCID http://orcid.org/0000-0001-5191-4847
Craig P HershChanning Division of Network Medicine, Brigham and Women's Hospital, 181 Longwood Avenue, Boston, MA, 02115, USA. craig.hersh@channing.harvard.edu.ORCID http://orcid.org/0000-0002-1342-4334

Funding

Genetic Epidemiology of COPDU01HL089897 · NHLBI · NATIONAL JEWISH HEALTH · PI CRAPO, JAMES D · 2007 to 2021
$56.9M
Biomarker of Lung Disease in African AmericansR01HL137995 · NHLBI · NATIONAL JEWISH HEALTH · PI BOWLER, RUSSELL PAUL, KECHRIS-MAYS, KATHERINA · 2018 to 2021
$3.4M
Defining a gene expression signature of airway disease, COPD exacerbations, and response to treatmentR01HL166231 · NHLBI · BRIGHAM AND WOMEN'S HOSPITAL · PI CRAIG P HERSH · 2023 to 2026
$3.3M
NHLBI NIH HHS R01 HL137995NHLBI NIH HHS R01 HL166231NHLBI NIH HHS U01 HL089897NIH HHS R01HL137995NIH HHS R01HL166231NIH HHS U01HL089897
6 · The paper itself

Abstract

backgroundBlood eosinophil count is an accepted biomarker for type 2 inflammation in COPD. However, the majority of COPD patients are characterized by non-type 2 inflammation. We aimed to test readily obtainable immune cell ratios as biomarkers for clinical phenotypes in the broad COPD population and to determine pathways represented by these ratios using multi-omics data.

methodsUsing complete blood counts with differential collected at the Phase 2 (5-year) visit in the COPDGene Study, we calculated three immune cell ratios previously described in COPD and other diseases: the neutrophil–lymphocyte ratio (NLR), the platelet-lymphocyte ratio (PLR), and the Systemic Immune-Inflammation Index (SII = NLR*platelets). We tested for associations with COPD outcomes, including lung function, chest CT scan phenotypes, and exacerbations. Blood RNA-sequencing and proteomics data were used to identify genes, proteins and pathways associated with the ratios.

resultsIn univariate analyses, the three biomarkers were associated with COPD severity measures. In zero inflated Poisson regression models, all three were associated with increased odds of having an exacerbation but were not associated with exacerbation counts. Conversely, the three biomarkers were generally associated with prospective exacerbation counts, but not the zero-inflation term. In logistic regression models, the three biomarkers were significantly associated with having two or more exacerbations in the prior year; however, receiver operating characteristic analyses did not lead to clear cutoff values. Complement and PI3K signaling pathways were enriched across more than one ratio in both the RNA-sequencing and proteomics results. Other inflammatory pathways relevant in COPD appeared in different enrichment sets in either omics data type.

conclusionsHigher levels of three easily obtained blood cell ratios were associated with COPD severity and exacerbations outcomes; however, there are not clear thresholds which would be required for clinical application. Blood RNA-sequencing and proteomics identified inflammatory pathways associated with the three biomarkers, including targets for COPD therapies currently in human trials.

Indexed as

InflammationNeutrophilsPulmonary Disease, Chronic ObstructiveAgedBiomarkersFemaleHumansMaleMiddle AgedProspective StudiesProteomicsBiomarkersCOPD exacerbationLymphocytesNeutrophilsPlateletsProteomicsRNA-sequencing

Identifiers

PMID41851771
PMCPMC13113035

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LicenceCC BY
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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.