Validation of Sputum Biomarker Immunoassays and Cytokine Expression Profiles in COPD

Immunoassays are commonly used to assess airway inflammation in sputum samples from chronic obstructive pulmonary disease (COPD) patients. However, assay performance and validation in this complex matrix is inconsistently reported. The aim of this study was to assess the suitability of various immunoassays for use with sputum samples, followed by use of validated immunoassays to evaluate biomarker levels in COPD patients. Assays were assessed for recombinant reference standard suitability, optimal sample dilution, standard recovery in the biological matrix and reproducibility. Validated assays were used to assess sputum supernatants in Cohort A (n = 30 COPD, n = 10 smokers, n = 10 healthy) and Cohort B (n = 81 COPD, n = 15 smokers, n = 26 healthy). Paired baseline and exacerbation samples from 14 COPD patients were assessed in cohort A, and associations with sputum cell counts and bacterial colonisation investigated in cohort B. 25/32 assays passed validation; the primary reason for validation failure was recombinant reference standard suitability and sample dilution effects. Interleukin (IL-)6 and IL-8 were significantly increased in COPD patients compared to healthy subjects and smokers for both cohorts. Tumour necrosis factor (TNF)alpha and IL-1 beta were higher in COPD compared to smokers using one immunoassay but not another, partly explained by different absolute recovery rates. IL-1 beta, IL-2, IL-4, IL-8, IL-17A, Granulocyte colony stimulating factor (G-CSF), Interferon (IFN-)gamma, Interferon gamma induced protein (IP-)10, Macrophage inflammatory protein (MIP)-1 alpha, MIP-1 beta and TNF-alpha levels correlated with sputum neutrophil percentage in COPD patients. IL-1 beta, IL-4, IL-8, G-CSF and IFN-gamma levels were associated with Haemophilus influenzae colonisation in COPD patients. Current smokers had lower levels of IL-1 beta, IL-4, IL-8, G-CSF, IFN-gamma, IP-10, Monocyte chemoattractant protein (MCP)-1, MIP-1 alpha, MIP-1 beta and TNF-alpha. Validated immunoassays applied to sputum supernatants demonstrated differences between COPD patients and controls, the effects of current smoking and associations between Haemophilus influenzae colonisation and higher levels of selected cytokines. Immunoassay validation enabled inflammatory mediators associated with different COPD characteristics to be determined.