Exploring the relationship between Diaphragmatic Ultrasound and Specialized Pro-resolving Mediators in Chronic Obstructive Pulmonary Disease

Abstract

<bold>Introduction:</bold> Recent research has spotlighted the promise of diaphragmatic ultrasound (DUS) and specialized pro-resolving mediators (SPMs) in unraveling Chronic obstructive pulmonary disease (COPD) complexities. This study endeavors to explore the dynamic correlation between DUS findings and SPM levels. <bold>Methods:</bold> We conducted a prospective study on 40 consenting stable COPD patients according to the GOLD 2023 guidelines at our pulmonology department from October to December 2023. Patients with known or suspected co-morbidities affecting SPMs levels or respiratory diseases related to COPD were excluded. Blood samples for SPMs (Lipoxins A4 and B4, Resolvins D1 and D5, 15-epi-lipoxin A4, 6-epi-lipoxin A4, 7,17-hydroxy Docosapentaenoic acid) along with spirometry, were collected. Ultrasound measured diaphragmatic thickening (DT), thickening fraction (TF), and maximum diaphragmatic excursion (DEmax). <bold>Results:</bold> The mean age was 63.78 ± 7 years. COPD was classified as group B in 40% and group E in 40% of cases. The median TF was 22.8 mm (22.58 - 24.29 mm). A significant canonical correlation existed between ultrasound parameters and SPMs. DT correlated with Lipoxins and epi-lipoxins in Group E patients (r = −0.377; P < 10^-3). DEmax was lower in patients with anorexia, with severe bronchial obstruction, and with CAT scores > 20. Notably, Resolvin D5 negatively correlated with TF in chronic respiratory failure patients (r = −0.347; P < 10^-3). TF and 15-Epi-LXA4 both predicted COPD exacerbation risk with an odds ratio of 2.5 (CI: 1.323 - 6.918). <bold>Conclusion:</bold> Our study uncovers the potential of combining DUS and SPMs for personalized COPD management.