Predictive value of serum interleukin-33 and thymic stromal lymphopoietin for the risk of acute exacerbation in patients with chronic obstructive pulmonary disease

Background Acute exacerbation in patients with chronic obstructive pulmonary disease (COPD) lacks reliable biomarkers. This study aimed to explore the predictive value of serum interleukin-33 (IL-33) and thymic stromal lymphopoietin (TSLP) for acute exacerbations of COPD (AECOPD). Methods This retrospective study included patients with stable-phase COPD between June 2023 and June 2024 at the Third Affiliated Hospital of Anhui Medical University. Patients were assigned to the low-risk and high-risk groups according to the number and severity of AECOPD events. Multivariable logistic regression analysis was used to identify the factors of AECOPD risk. Receiver operating characteristic (ROC) curves were used to assess the predictive value of IL-33 and TSLP for AECOPD risk. Results A total of 76 patients were enrolled, with 33 in the low-risk group and 43 in the high-risk group. Serum IL-33 (835.30 vs. 770.30, p = 0.008) and TSLP (102.20 vs. 90.45, p < 0.001) levels were higher in the high-risk group than in the low-risk group. Serum TSLP (odds ratio (OR) = 1.095, 95% confidence interval (CI): 1.013–1.184, p = 0.022) was independently associated with AECOPD. The area under the curve (AUC) for IL-33 in predicting AE was 0.677 (95%CI: 0.554–0.801), with 93.0% sensitivity and 39.4% specificity. The AUC for TSLP was 0.768 (95%CI: 0.659–0.878), with 76.7% sensitivity and 72.7% specificity. Combined prediction using IL-33 and TSLP yielded an AUC of 0.779 (95%CI: 0.669–0.888), with 81.4% sensitivity and 72.7% specificity. Conclusion High serum TSLP might be associated with an increased risk of AECOPD. While IL-33 alone showed high sensitivity and low specificity, its potential predictive value may be worth exploring.