ArticleFrontiers in medicine2026
Plasma kynurenine to tryptophan ratio and arginine as biomarkers associated with GOLD classification and predicting poor prognosis in patients with acute exacerbation of chronic obstructive pulmonary disease.
Article in Frontiers in medicine, 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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Abstract
Background: Acute exacerbation of chronic obstructive pulmonary disease (AECOPD) is life-threatening with limited prognostic biomarkers. The kynurenine pathway and arginine (Arg) metabolism are linked to COPD inflammation, but their relevance to GOLD classification and prognosis in AECOPD remains elusive. This study aimed to explore plasma kynurenine (Kyn) to tryptophan (Trp) ratio (KTR) and Arg as potential prognostic biomarkers. Methods: 176 AECOPD patients (Fuyang People's Hospital, May 2022-March 2024) and 60 age/sex-matched healthy controls were enrolled. AECOPD patients were grouped into poor (80 cases: 1-year death/readmission) and good (96 cases) prognosis groups, all receiving 2022 GOLD-guided treatment. Plasma Kyn, Trp, and Arg were quantified via UPLC-MS/MS. Correlations of KTR/Arg with GOLD classification, their prognostic value, and plasma metabolic differences among the three groups were analyzed. Results: Compared with the good prognosis group, the poor prognosis group exhibited significantly higher Kyn and KTR levels, a higher proportion of GOLD grade 3/4 patients, and lower Trp and Arg levels (all Conclusion: Plasma KTR and Arg levels in AECOPD patients are positively correlated with severe pulmonary function and poor prognosis, indicating a close association with prognosis and supporting their potential as novel biomarkers for prognostic stratification in this population.
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