Abstract
Introduction: The global burden of chronic airway diseases represents an important public health concern. The role of oxidative stress and inflammation in the pathogenesis of these diseases is well known. The aim of this study is to evaluate the behavior of both inflammatory and oxidative stress biomarkers in patients with chronic bronchitis, current asthma and past asthma in the frame of a population-based study. Methods: For this purpose, data collected from the Gene Environment Interactions in Respiratory Diseases (GEIRD) Study, an Italian multicentre, multicase-control study, was evaluated. Cases and controls were identified through a two-stage screening process of individuals aged 20-65 years from the general population. Out of 16,569 subjects selected from the general population in the first stage of the survey, 2259 participated in the clinical evaluation. Oxidative stress biomarkers such as 8-oxo-7,8-dihydro-2′-deoxyguanosine (8-oxodG), 8-isoprostane and glutathione and inflammatory biomarkers such as Fractional Exhaled Nitric Oxide (FENO) and white blood cells were evaluated in 1878 subjects. Results: Current asthmatics presented higher levels of FENO (23.05 ppm), leucocytes (6770 n/µL), basophils (30.75 n/µL) and eosinophils (177.80 n/µL), while subjects with chronic bronchitis showed higher levels of GSH (0.29 mg/mL) and lymphocytes (2101.6 n/µL). The multivariable multinomial logistic regression confirmed high levels of leucocytes (RRR = 1.33), basophils (RRR = 1.48), eosinophils (RRR = 2.39), lymphocytes (RRR = 1.26) and FENO (RRR = 1.42) in subjects with current asthma. Subjects with past asthma had a statistically significant higher level of eosinophils (RRR = 1.78) with respect to controls. Subjects with chronic bronchitis were characterized by increased levels of eosinophils (RRR = 2.15), lymphocytes (RRR = 1.58), GSH (RRR = 2.23) and 8-isoprostane (RRR = 1.23). Conclusion: In our study, current asthmatics show a greater expression of the inflammatory profile compared to subjects who have had asthma in the past and chronic bronchitis. On the other hand, chronic bronchitis subjects showed a higher rate of expression of oxidative stress biomarkers compared to asthmatic subjects. In particular, inflammatory markers such as circulating inflammatory cells and FENO seem to be more specific for current asthma, while oxidative stress biomarkers such as glutathione and 8-isoprostane appear to be more specific and applicable to patients with chronic bronchitis.
Highlights
The global burden of chronic airway diseases represents an important public health concern
The main results derived from our study can be summarized as follows: (1) Current asthmatics show, compared to subjects who have had asthma in the past and chronic bronchitis, a greater expression of the inflammatory profile in terms of Fractional Exhaled Nitric Oxide (FENO) levels in the airways and an increase in leukocytes, basophils, lymphocytes and, most importantly, eosinophils counts in peripheral blood
(2) Chronic bronchitis subjects, compared to current asthmatics and individuals who have suffered from asthma in the past, have a greater expression of oxidative stress biomarkers in terms of serum glutathione
Summary
The global burden of chronic airway diseases represents an important public health concern. The aim of this study is to evaluate the behavior of both inflammatory and oxidative stress biomarkers in patients with chronic bronchitis, current asthma and past asthma in the frame of a population-based study. The global burden of chronic airway diseases is increasing as an effect of the aging of the world’s populations and represents a major public health concern. Among these diseases, asthma is a common condition characterized by chronic airway inflammation and hyperresponsiveness resulting in repeated attacks of wheezing and breathlessness [1]. Chronic bronchitis symptoms presence correlates with forced expiratory volume in 1 s (FEV1) decline and it is associated with worse health status in affected subjects [6]
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