Cumulative effect of rheumatoid arthritis on chronic obstructive pulmonary disease

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Objective To analyze the difference of clinical manifestations and serum levels of biomarkers between chronic obstructive pulmonary disease (COPD) patients and rheumatoid arthritis (RA) patients combined with COPD, and to reveal the cumulative effect and molecular mechanism of RA on the natural course of COPD. Methods In the study, a total of 41 patients with COPD and 43 RA patients with COPD were collected.The clinical indexes and laboratory indexes were recorded carefully in the enrolled patients.Furthermore, two-sample t-test, Wilcoxon rank sum test and Pearson correlation analysis were used for statistical analysis. Results There was no significant difference of lung function indexes [inspiratory capacity (IC), forced expiratory volume in one second (FEV1), forced vital capacity (FVC), FEV1/FVC, FEV1% pred, residual volume (RV)%pred, total lung capacity (TLC)%pred, RV/TLC%, vital capacity%pred and carbon monoxide diffusing capacity%pred] between the two groups (P>0.05). The levels of anti-cyclic citrullinated peptide and rheumatoid factor in RA patients combined with COPD were significantly higher than those in COPD group, and the difference was statistically significant (t=16.259, 23.598, both P 0.05). Compared with COPD patients, the serum levels of interleukin-17 (IL-17), erythrocyte sedimentation rate, C-reactive protein (CRP) and IL-6 were significantly increased in rheumatoid arthritis patients combined with COPD, indicating statistical difference (P 0.05). IL-17 was negatively correlated with 6MWD (r=-0.535, P<0.01). IL-6 was negatively correlated with 6MWD(r=-0.516, P<0.01). CRP was negatively correlated with 6MWD (r=-0.233, P<0.05). Conclusions RA promotes the natural progression of COPD and has a cumulative effect on the pathogenesis of COPD. Key words: Chronic obstructive pulmonary disease; Rheumatoid arthritis; Interleukin-17