The predictive value of combined detection of serum IL-33, TSLP and eosinophils in the treatment effect and exacerbation risk of chronic obstructive pulmonary disease.

backgroundChronic obstructive pulmonary disease (COPD) is a prevalent respiratory condition with high morbidity and mortality. This study aimed to investigate the relationship between interleukin-33 (IL-33), thymic stromal lymphopoietin (TSLP), and eosinophilic granulocyte (EOS) levels and the treatment effect and exacerbation risk of COPD.

methodsA total of 225 COPD patients who were diagnosed and treated in our hospital from October 2021 to September 2024 were selected as the research objects for retrospective analysis and study, and were recorded as the COPD group. 200 subjects who underwent physical examination in our hospital at the same period were selected as the control group. The serum levels of IL-33, TSLP and EOS were compared between the two groups. The patients were divided into the effective group (102 cases) and the ineffective group (123 cases) according to the reduction of chronic obstructive pulmonary disease assessment test (CAT) score not less than 2 points or lung function grade not less than 1 grade after 1 week of treatment (considered effective). After a 12-month follow-up, patients were further divided into acute exacerbation (n = 104) and non-acute exacerbation (n = 121) groups according to the occurrence of acute exacerbation (patients' clinical symptoms deteriorated beyond the daily range in a short period of time and needed to change treatment). The changes of serum IL-33, TSLP and EOS levels in patients with different treatment effects and exacerbation risks were detected. The receiver operating characteristic (ROC) curve was used to analyze the predictive value of serum IL-33, TSLP and EOS alone and in combination for the treatment effect and malignant risk of COPD. Multivariate Logistic regression was used to analyze the influencing factors of ineffective treatment and exacerbation in COPD patients.

resultsPatients with COPD showed higher serum IL-33 and EOS levels and lower TSLP compared to the control group (P < 0.05). Compared with the effective group, patients in the ineffective group showed significantly higher serum levels of IL-33 and EOS and a significantly lower level of TSLP (P < 0.05). Patients in the acute exacerbation group showed higher serum levels of IL-33 and EOS and a lower level of TSLP than the non-acute exacerbation group (P < 0.05). The area under the curve (AUC) of serum IL-33, TSLP, and EOS in detecting the treatment effect of COPD was 0.803, 0.778, and 0.870, respectively. The AUC of combined detection was 0.938, suggesting that the combined detection had a higher predictive value. The AUC for IL-33, TSLP, and EOS were 0.679, 0.716, and 0.891, respectively, with a combined detection AUC of 0.931. For the assessment of COPD exacerbation risk, the combined detection of three indicators had higher clinical value. Multivariate Logistic regression analysis showed that after adjusting for confounding factors such as age, sex, smoking status, and basic pulmonary function, elevated serum IL-33 and EOS levels were still independent risk factors for treatment failure (P < 0.05), while elevated TSLP level was a protective factor (P < 0.05). In terms of predicting the risk of acute exacerbation, the elevated EOS level was an independent risk factor (P < 0.001), and the independent predictive value of IL-33 and TSLP did not reach statistical significance (P > 0.05).

conclusionThe levels of IL-33 and EOS were significantly increased, and the level of TSLP was significantly decreased in patients with effective treatment and acute exacerbation of COPD. The above indicators could be used as important indicators to predict the treatment effect and malignant risk of COPD, and the combined detection had high sensitivity and specificity.