ABSTRACT: It has been recognized that COPD holds metabolic characteristics. however, at present, the early intervention of COPD is also still insufficient because of lacking effective biomarkers. Therefore, it is necessary to systematically and comprehensively explore the metabolic characteristics of COPD developing acute exacerbation. In the study, a non-targeted metabolomics strategy was used in exploring the metabolic profiling of COPD, AECOPD and heathy controls samples and screening potential biomarkers of metabolic disorders related to AECOPD, to analyze the potential value of these metabolites in predicting the development of COPD. For COPD patients, serum lysine, glutamine, 3-hydroxybutyrate, pyruvate and glutamate levels were significantly higher, while 1-methylhistidine, isoleucine, choline, valine, alanine, histidine and leucine levels were significantly lower in AECOPD patients compared with stable COPD patients after normalization based on the heathy controls. moreover, eight metabolic pathways were significantly altered (P < 0.05) in the serum of AECOPD patients compared with the stable COPD population, including purine metabolism, glutamine and glutamate metabolism, arginine biosynthesis, butyrate metabolism, ketone body synthesis and degradation, and linoleic acid metabolism. In addition, analysis of the correlation between stable COPD and AECOPD patients with pulmonary ventilation function and symptoms demonstrated that the levels of pyruvate, isoleucine, 1-methylhistidine and glutamine were significantly correlated with pulmonary ventilation function in COPD patients. Altogether, the study provides new insights for the early detection, treatment and prognosis monitoring of COPD development.
Chao Zhou 
