ПОРУШЕННЯ БАЛАНСУ ПРО-ТА ПРОТИЗАПАЛЬНИХ ЦИТОКІНІВ У ПАЦІЄНТІВ З ЛЕГЕНЕВОЮ ГІПЕРТЕНЗІЄЮ НА ТЛІ ХРОНІЧНОГО ОБСТРУКТИВНОГО ЗАХВОРЮВАННЯ ЛЕГЕНЬ З СУПУТНЬОЮ ІШЕМІЧНОЮ ХВОРОБОЮ СЕРЦЯ

Abstract

Chronic obstructive pulmonary disease (COPD) is an inflammatory disease of the lung associated with progressive airflow limitation. There is growing recognition that the inflammatory state associated with COPD is not confined to the lungs but also involves the systemic circulation and can impact nonpulmonary organs. However, there is insufficient data on the potential role of systemic inflammation in the formation of pulmonary hypertension, secondary to COPD. Thus, our goal was to investigate the degree of systemic inflammation that is reflected in the level of interleukin-4 and interleukin (IL-2) exchange in patients with COPD and coronary artery disease (IHD) with and without pulmonary hypertension. METHODS: 121 patients with COPD and stable coronary heart disease (mean age [M +/- SD], 60.7 ± 9.7 years, mean FEV1, 46.2 ± 18.1%) were screened into the study, mean pulmonary artery preasure was measured using echocardiography. Osteopontin and IL-2 levels in the serum were evaluated using ELISA kits. Patients were divided into 2 groups: 1 group with signs of pulmonary hypertension (68 patients); and 53 patients without Pulmonary hypertension (2-group). RESULTS: IL-2 concentrations were in 1 group - 9.8 [7.3; 13.1] and 2.2 [0.9; 3.0] in 2 group respectively. For IL-4, the levels were 2.5 [1.8; 2.9] – 1 group, and in the control group (without PH) 3.5 [0.59; 10.0] does not exceed the values of healthy donors. Correlation analysis shows that in the first group there was a positive correlation between the duration of COPD and the level of IL-2 (r = 0.33, p = 0.04) and the negative correlation between osteopontin, IL -2 with a FEV1 (r = -0.84); FLC (r = -0.55). There is a high correlation between osteopontin (r = -0.45), IL-2 (r = -0.60), and a 6-minute walk test and IL-2 and the Borg dyspnea scale (r = 0, 42) after a 6-minute walk test. Pulmonary hypertension is associated with increased levels of systemic inflammatory markers which may have important pathophysiological and therapeutic implications for subjects with stable COPD and CAD.