A combination of 4 blood proteins may serve as biomarkers to help clinicians distinguish patients with asthma from those with chronic obstructive pulmonary disease (COPD).

• Better diagnosis could lead to improved management of these conditions and a better understanding of their pathogenesis
• The biomarkers were identified through proteomics, which can simultaneously identify multiple proteins associated with different disease states and potentially discover novel proteins not previously associated with particular disease states.
• To conduct their study, the researchers first collected blood samples from 3 clinical groups: 21 patients with asthma, 5 patients with COPD, and 17 healthy control individuals.
  
• Using a technique called 2-dimensional difference gel electrophoresis; the investigators identified 20 unique plasma proteins as potential candidate markers.
• The proteins fell into 3 general functional groups: iron metabolism, the coagulation cascade, and various complement pathways
• Patients with COPD had serum levels of prothrombin, another coagulation protein, that were significantly lower than the levels seen in asthmatic patients.
• The findings suggest that 4 proteins — ceruloplasmin, haptoglobin, hemopexin, and α-2-macroglobulin — can be used in combination to identify patients with asthma and COPD
• For example, in the younger patients, the combination of ceruloplasmin and haptoglobin are best for discriminating between asthmatic and healthy control patients, whereas in the older patients, haptoglobin and hemopexin are more effective.
• This proteomic discovery program has identified a panel of protein markers whose serum concentrations are significantly altered in asthma and COPD compared with age and sex matched healthy controls, and whose function points to novel mechanistic pathways indicating the involvement of the iron metabolism pathways, complement pathways, and the coagulation cascade in asthma and COPD.
• This panel of biomarkers has the potential to become an extremely useful addition to the clinical diagnosis and management of respiratory disease.

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