Select Airway Specialized Proresolving Mediators Are Associated with Recovery from Nonviral Chronic Obstructive Pulmonary Disease Exacerbations

作者：Lydia Finney, Jordina Mah, Melody G. Duvall, Dexter Wiseman, Faisal Kamal, Peter Fenwick, Andrew I. Ritchie, Tata Kebadze, Christopher M. Orton, Pankaj Bhavsar, James P. Allinson, Mairi Macleod, Alexander Mackay, Federico Baraldi, Samuel V. Kemp, Aran Singanayagam, Sebastian L. Johnston, Adam J. Byrne, Bruce D. Levy, Jadwiga A. Wedzicha · 发表于：American Journal of Respiratory and Critical Care Medicine · 年份：2025 · DOI：10.1164/rccm.202407-1325oc · 被引用次数：9 · 研究领域：Neonatal Respiratory Health Research、Fatty Acid Research and Health、Macrophage Migration Inhibitory Factor

Abstract Rationale Recovery from chronic obstructive pulmonary disease (COPD) exacerbations is heterogeneous and has a profound impact on disease trajectories. Resolution of airway inflammation is an active process that may be driven by specialized proresolving mediators (SPMs). Objectives We sought to characterize the temporal change in SPMs in the sputum of patients with COPD during exacerbations, their association with exacerbation triggers, and exacerbation recovery. Methods Participants were recruited from the London COPD Exacerbation Cohort between January 11, 2016, and April 30, 2018. Participants were reviewed at baseline, exacerbation onset, 1 week, 2 weeks, and 6 weeks during their exacerbation recovery. Sputum collection, nasopharyngeal swabs, phlebotomy, quality-of-life questionnaires, and spirometry were performed at each visit. SPMs were measured in sputum by liquid chromatography–tandem mass spectrometry. Respiratory viruses were measured by quantitative PCR and bacteria by microbiological culture. Measurements and Main Results There were 68 exacerbations during the study period. Median time to symptomatic recovery was 21 days for viral exacerbations, compared with 13 days in nonviral exacerbations (P < 0.001). There was a significant increase in resolvin D1 (RvD1) at exacerbation onset in bacterial exacerbations but not in viral exacerbations. Lower levels of RvD1 were associated with prolonged respiratory symptoms during the 1-week and 2-week recovery ...