ABSTRACT
Definitions of chronic obstructive pulmonary disease (COPD) make reference to an abnormal inflammatory response within the lung (1). It is now widely accepted that stable COPD is also associated with heightened systemic inflammation (2). The first part of this chapter examines evidence that exacerbations of COPD are associated with further rises in airway and systemic inflammatory markers. Examining changes in inflammation at exacerbation might be considered an academic pursuit, providing insights into the underlying mechanisms of disease but of little use to the practicing clinician. However, if changes in inflammation also inform on parameters of clinical utility, such as exacerbation etiology or severity, then such a phenomenon, objectively measured and evaluated, would fulfill the definition of a ‘biomarker’ (3) and be of considerable practical importance. The second part of this chapter therefore considers the utility of measuring airway and systemic biomarkers at exacerbation of COPD.
