Blood <i>MALT1</i> reflects acute exacerbation risk and inflammation in elderly chronic obstructive pulmonary disease patients

<b>Aim:</b> This study intended to investigate the ability of blood <i>MALT1</i> to estimate acute exacerbation risk in elderly chronic obstructive pulmonary disease (COPD) patients. <b>Methods:</b> Blood <i>MALT1</i> was detected in 176 elderly COPD patients (aged more than 60 years). <b>Results:</b><i>MALT1</i> was elevated in patients with COPD acute exacerbation versus patients with stable COPD (<i>p</i> &lt; 0.001). In patients with COPD acute exacerbation, <i>MALT1</i> was negatively related to forced expiratory volume in 1 s (FEV₁)/forced vital capacity (FVC) (<i>p</i> = 0.024) and FEV₁% predicted (<i>p</i> = 0.002), but positively linked with global initiative for chronic obstructive lung disease stage (<i>p</i> = 0.005). <b>Conclusion:</b> Blood <i>MALT1</i> reflects increased acute exacerbation risk and inflammation in elderly COPD patients. Elderly chronic obstructive pulmonary disease (COPD) patients benefit less from the treatment, and uncontrolled disease conditions result in acute exacerbation, leading to poor clinical outcomes in these patients. Therefore, exploring potential markers that estimate the disease severity is essential to enhance the prognosis of elderly COPD patients. This study intended to explore the ability of <i>MALT1</i> expression to estimate acute exacerbation risk in elderly COPD patients. This study consecutively enrolled 176 elderly COPD patients and 30 healthy controls (HCs). <i>MALT1</i> expression was detected from peripheral blood mononuclear cells by reverse transcription quantitative real-time polymerase chain reaction in elderly COPD patients and HCs. <i>MALT1</i> expression was increased in elderly COPD patients compared with HCs. According to the receiver operating characteristic (ROC) curve, <i>MALT1</i> expression had a good ability to distinguish elderly COPD patients from HCs. <i>MALT1</i> expression was positively related to TNF-α, IL-6, IL-8 and IL-17A in elderly COPD patients. <i>MALT1</i> expression was positively related to TNF-α, IL-6, IL-8 and IL-17A in patients with COPD acute exacerbation. <i>MALT1</i> expression was only positively associated with TNF-α and IL-8 in patients with stable COPD. <i>MALT1</i> expression was raised in patients with COPD acute exacerbation versus patients with stable COPD. The ROC curve suggested that <i>MALT1</i> expression exhibited a certain capacity to discriminate patients with COPD acute exacerbation from patients with stable COPD. <i>MALT1</i> expression was negatively related to forced expiratory volume in 1 second (FEV₁)/forced vital capacity (FVC) and FEV₁% predicted in patients with COPD acute exacerbation. <i>MALT1</i> expression was positively linked with the global initiative for chronic obstructive lung disease stage in patients with COPD acute exacerbation. <i>MALT1</i> expression estimates increased acute exacerbation risk and inflammation in elderly COPD patients; meanwhile, it also represents a higher severity in patients with COPD acute exacerbation.