The role and clinical significance of myeloperoxidase (MPO) and TNF-α in prognostic evaluation of T-COPD.

PURPOSE: Chronic obstructive pulmonary disease (COPD) is a progressive inflammatory disorder that requires effective biomarkers for assessing disease activity and severity. This study aimed to compare clinical characteristics, inflammatory biomarker levels, and pulmonary function between stable COPD (S-COPD) and treated COPD (T-COPD) patients, with a focus on the prognostic value of inflammatory markers such as TNF-α, MPO, and IL-6. METHODS: A total of 81 patients were enrolled in the study, including 39 with stable COPD (S-COPD) and 42 with treated COPD (T-COPD). Clinical characteristics, lung function (measured by FEV1%), and inflammatory biomarkers (IL-6, MMP-9, SAA, MPO, TNF-α, and others) were assessed. Inflammatory biomarkers were compared between the two groups, and their associations with pulmonary function were examined using correlation and regression analyses. Prognostic value was assessed using ROC curve analysis. RESULTS: The T-COPD group exhibited significantly more severe disease, with higher rates of exacerbations, worse quality of life (CAT and mMRC scores), and reduced lung function (FEV1%, 6-minute walk distance). Inflammatory biomarker analysis revealed no significant differences for IL-6, MMP-9, SAA, RDW, LCN2, PLR, and NLR, but TNF-α and MPO were significantly higher in T-COPD patients (P = 0.015 and P = 0.012, respectively). Among these biomarkers, MPO and TNF-α showed strong negative correlations with FEV1% in T-COPD patients (r = -0.521 and r = -0.459, respectively). ROC curve analysis indicated that TNF-α (AUC = 0.821) was the most predictive biomarker, followed by MPO (AUC = 0.785) and IL-6 (AUC = 0.711). Combining TNF-α and MPO provided the best prognostic performance (AUC = 0.878). CONCLUSION: TNF-α, MPO, and IL-6 are significant biomarkers associated with disease severity and pulmonary function in T-COPD patients. The combination of TNF-α and MPO offers superior prognostic value, suggesting that these biomarkers may serve as useful tools for monitoring disease progression and guiding treatment decisions in treated COPD patients.