Abstract
Background Chronic Obstructive Pulmonary Disease (COPD) is characterized by persistent inflammation, airflow limitation, and progressive tissue destruction. While smoking is a major risk factor, recent research links innate immune mechanisms, oxidative stress, and protease imbalances to disease chronicity. Objectives To investigate the involvement of innate immune markers, neutrophil elastase (NE), macrophage elastase (MMP-12), and oxidative stress parameters (MDA and GSH) in COPD patients during acute exacerbations. Methods A case-control study was conducted on 60 participants (30 COPD patients and 30 healthy controls) in Baghdad from May 2024 to February 2025. Serum NE and MMP-12 levels were measured via ELISA. Oxidative stress was assessed through serum malondialdehyde (MDA) and glutathione (GSH) concentrations. Statistical analysis was performed using T-tests and ROC analysis. Results NE and MMP-12 levels were significantly elevated in COPD patients compared to controls (p