COPD: Journal of Chronic Obstructive Pulmonary Disease, 8:139–141, 2011
ISSN: 1541-2555 print / 1541-2563 online
Copyright C ; 2011 Informa Healthcare USA, Inc.
Ron Balkissoon, MD, DIH, MSc.FRCP
National Jewish Health, Denver, Colorado
Serum PARC/CCL-18 Concentrations and Health Outcomes in Chronic Obstructive Pulmonary Disease. D.D. Sin,
B. Miller, A. Duvoix, S.F. Man, X. Zhang, E.K. Silverman, J.E.
Connett, N.A. Anthonisen, R.A. Wise, D. Tashkin, B.R. Celli,
L. Edwards, N. Locantore, W. Macnee, R. Tal-Singer, D.A.
Lomas, on behalf of the ECLIPSE Investigators. Am J Respir
Crit Care Med. 2011 Jan 14. [Epub ahead of print]
RATIONALE: There are no accepted blood based
biomarkers in chronic obstructive pulmonary disease
(COPD). Pulmonary and activation-regulated chemokine
(PARC/CCL-18) is a lung-predominant inflammatory
protein that is found in serum.
OBJECTIVES: To determine whether PARC/CCL-18 levels are elevated and modifiable in COPD and to determine
their relationship to clinical endpoints of hospitalization and
MEASUREMENTS: PARC/CCL-18 was measured in
serum samples from individuals who participated in the
ECLIPSE (Evaluation of COPD Longitudinally to Identify
Predictive Surrogate Endpoints), and LHS (Lung Health
Study) studies and a prednisolone intervention study.
RESULTS: Serum PARC/CCL-18 levels were higher in
COPD than in smokers or lifetime non-smokers without
COPD ( 105 ng/mL vs 81 ng/mL vs 80 ng/mL; p < .0001). Elevated PARC/CCL-18 levels were associated with increased
risk of cardiovascular hospitalization or mortality in the LHS
cohort and with total mortality in the ECLIPSE cohort.
CONCLUSIONS: Serum PARC/CCL-18 levels are elevated in COPD and track clinical outcomes. PARC/CCL-
18, a lung-predominant chemokine, could be a useful blood
biomarker in COPD. www.clinicaltrials.gov NCT00292552.
Comments: To move forward in developing new drugs
for COPD it is important that we have a better under-
standing of the pathogenesis of COPD and have useful
biomarkers to differentiate sub-phenotypes, response to
therapy and perhaps prognosis. PARC/CCL-18 may have
advantages over other biomarkers such as CRP as it is se-
creted predominantly (but not exclusively) in the lung by
monocytes/macrophages and dendritic cells. The fact that
the assessment of this biomarker in the blood had better
correlations with cardiovascular mortality than with such
things as FEV-1 or GOLD stage could reflect that PARC
tracks extra-pulmonary manifestations of COPD better
than the process in the lungs. It is likely that a number of
new biomarkers will be needed to adequately follow the
pulmonary and extrapulmonary effects of COPD.
Correspondence to: Ron Balkissoon, MD, DIH, MSc.FRCP, National Jewish Health, 1400 Jackson Street Denver, CO 80206, USA. email: