BLOOD BIOMARKERS measured in middle age could help distinguish patterns of lung function associated with increased chronic obstructive pulmonary disease (COPD) risk, according to a long-running Australian study.
Researchers linked blood measurements at age 53 years with lung function trajectories extending back to childhood. Their findings suggest that biological signals associated with established COPD may also help characterise the pathways through which the disease develops.
The study offers a potential approach to understanding an individual’s lung function history when repeated measurements from childhood are unavailable. However, the findings do not yet establish a blood test for predicting future COPD.
The research used data from the Tasmanian Longitudinal Health Study, which collected lung function measurements between the ages of 7 and 53 years.
Investigators examined trajectories of the ratio between forced expiratory volume in 1 second and forced vital capacity, a measure used to assess airflow obstruction.
Six trajectories had been identified, including three associated with increased COPD risk. These comprised low lung function early in life followed by rapid decline, initially normal lung function followed by rapid decline, and early low lung function followed by a more typical rate of decline.
At age 53 years, researchers measured several blood proteins and inflammatory markers and examined their relationships with these patterns.
Levels of CC16, soluble receptor for advanced glycation end products, surfactant protein D, and interleukins 17A, 5 and 10 differed significantly between the pre-COPD trajectories and the normal trajectory.
The biomarkers also helped distinguish the two patterns involving rapid decline from the relatively stable pre-COPD pattern. An exploratory classification analysis identified combinations of biomarkers associated with different trajectories.
These results suggest that apparently similar levels of impairment in middle age may be accompanied by different biological profiles, reflecting distinct histories of lung function development and decline.
The clinical appeal is the possibility of combining blood biomarkers with clinical history to better characterise patients whose earlier lung function records are missing.
Nevertheless, the timing of measurement is important. Blood samples were collected at age 53 years and related to trajectories already observed over previous decades. This differs from demonstrating that a biomarker measured earlier can reliably predict subsequent disease.
Further research would therefore need to establish how well these profiles perform prospectively and whether using them improves clinical decisions or outcomes.
The authors conclude that biomarkers may eventually support identification and management of pre-COPD and COPD, particularly when interpreted alongside a patient’s clinical history. Wiley Online Library
Reference
Bui DS et al. Biomarkers of pre-COPD lung function trajectories in middle age: a prospective study from 1st to 6th decade. Respirology. 2026;31:993–1002. doi:10.1002/resp.70279.
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