Correlations Between Inflammatory Biomarkers and COPD Severity in a Real-Life Setting

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Background: With a steady increase in prevalence, chronic obstructive pulmonary disease (COPD) is recognized as a leading contributor to global mortality, which underscores the need to identify prognostic biomarkers that are easy to use in everyday practice. As both local and systemic inflammation play a pivotal part in the development and progression of COPD, the purpose of our study was to assess the role of inflammatory markers in estimating disease severity (GOLD 1 to 4) to guide the management and treatment of patients with COPD, thus helping to reduce episodes of decompensation and fatal outcomes in both immediate and long-term contexts. Methods: We performed a descriptive observational analysis with a cross-sectional design including 100 patients with stable COPD. All subjects underwent standard clinical examination, lung function tests and a comprehensive inflammation blood panel. Results: We included 55 patients with mild–moderate COPD (GOLD 1–2), 33 patients with advanced stages of COPD (GOLD 3) and 12 patients with very severe forms of the disease (GOLD 4). Male sex, smoking status, BMI, IL-1 beta, NLR, and nocturnal heart rate were parameters with significant value for assessing COPD severity (p < 0.05 for all). NLR correlates significantly with the predicted distance in the 6 MWT (p = 0.039). Significant associations were identified between IL-8 and duration of exposure of biomass fuel (p = 0.045) as well as between IL-6 and pack-years (p = 0.024), with both prognostic and therapeutic impact. Furthermore, the analysis of the total cohort revealed positive correlations between serum IL-6 and FVC (%) (p = 0.033) or NLR and the ratio between FEV1 and FVC (p = 0.048). The neutrophil-to-lymphocyte ratio (NLR) proved to be a reliable indicator of stages 3–4 GOLD (AUC 0.66, threshold value 2.3045, p = 0.004—a one-point increase in NLR corresponded to a 2.148 increase in FEV1). Conclusions: NLR emerged as a simple, accessible and highly informative biomarker in COPD, linked to disease severity and functional decline. Its integration into routine assessment could enhance prognosis and guide clinical decisions, a finding that warrants confirmation in future multicenter studies.

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