Clinical validity of blood and urinary desmosine as biomarkers for chronic obstructive pulmonary disease
Bibliographic record
Abstract
Background: Although the elevation of degraded elastin products in patients with COPD has been reported for many years, its clinical validity and utility remain uncertain due to technical difficulties, small study cohorts and unknown relationship between exacerbation and elastin degradation. Aims and objectives: To determine the validity of urinary and blood total desmosine/isodesmosine (uDES and bDES) as disease phenotyping biomarkers for COPD and to evaluate their relationship to exacerbation status. Methods: uDES and bDES were measured using validated isotopic dilution LC-MS/MS methods. Results: Two cohorts consisting of a total of 390 subjects including the following groups: healthy volunteers, stable asthma, stable COPD and COPD during an exacerbation were investigated. Compared to healthy non-smokers, we found increased bDES levels in patients with COPD regardless of exacerbation status (p<0.001, ANOVA), but no differences in patients with asthma or healthy smokers. A similar observation was found for uDES except that the elevation of uDES levels was associated with an exacerbation in COPD patients (12±5 vs. 20±12 ng/mg creatinine for stable and exacerbation, respectively, p<0.01, t test). Such an increase in COPD patients during an exacerbation was closely related to inflammation associated proteinuria (p<0.001, Spearman correlation). Approximately 40% of patients showed an “accelerated elastin degradation” phenotype based on their bDES levels in both stable COPD and COPD during an exacerbation. Conclusions: Our results strongly suggest that bDES is a valid biomarker for phenotyping “accelerated elastin degradation” subtype in COPD whilst uDES links to exacerbation.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.005 | 0.010 |
| Meta-epidemiology (narrow) | 0.001 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.000 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.000 | 0.001 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.001 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".