Response to the Letter of Kawada: Platelet Indices in COPD

Angelo Zinellu, Panagiotis Paliogiannis, Elisabetta Sotgiu, Sabrina Mellino, Alessandro G. Fois, Ciriaco Carru, Arduino A. Mangoni

Research output: Contribution to journalLetterpeer-review


To the Editor,

We agree with Dr Kawada that further prospective studies are required to confirm, or refute, the presence of a dose-effect relationship between specific platelet indices and the severity of chronic obstructive pulmonary disease (COPD). In our systematic review and meta-analysis, one such index, the platelet to lymphocyte ratio (PLR) was significantly associated with both the presence of COPD and its exacerbations, suggesting a dose-effect relationship with the disease. By and large, specific biomarkers for routine use in clinical practice should be easily measurable at a population level, should exhibit a predictable association with the presence and/or the severity of disease, and should potentially be modifiable by means of pharmacological and/or non-pharmacological interventions.
Original languageEnglish
Pages (from-to)483
Number of pages1
JournalCOPD: Journal of Chronic Obstructive Pulmonary Disease
Issue number4
Early online date7 Jul 2021
Publication statusPublished - 2021


  • platelet indices
  • COPD
  • disease severity
  • platelet to lymphocyte ratio
  • platelet biomarkers
  • non-platelet biomarkers


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