Detection of respiratory viruses and expression of inflammatory cytokines in patients with acute exacerbation chronic obstructive pulmonary disease in Mongolia China.

Y Feng,E Liu

doi:10.1590/1519-6984.231134

Abstract

Chronic obstructive pulmonary disease (COPD) was estimated to be the third cause of global mortality by 2020. Acute exacerbation COPD (AECOPD) is a sudden worsening of COPD symptoms and could be due to virus/bacterial infections and air pollution. Increased expression of inflammatory markers in patients with AECOPD is associated with viral infection. This study aimed to detect different viruses and analyze the expression of various inflammatory markers associated with AECOPD patients. Three hundred and forty-seven patients diagnosed with COPD according to GOLD criteria were included in this study. Swab samples and blood were collected for the detection of viruses by RT-PCR and expression of inflammatory markers, respectively. Of the swab samples, 113 (32.6%) of samples were positive for virus detection. Of these, HRV (39.8%) was the predominant virus detected followed by FluB (27.4%) and FluA (22.1%). The presence of HRV was significantly higher (p=0.044) among the other detected viruses. When compared to healthy controls the expression levels of TNF-α, IL-6 and IL-8 were significantly higher (p<0.05) in virus-positive patients. The IL-6 and IL-8 were the next predominantly expressed in markers among the samples. The higher expression rate of IL-8 was significantly (p<0.05) associated with patients having COPD GOLD III severity level and smoking history. Although HRV was the predominant virus detected the combined prevalence of Influenza A and B surpassing the rate of HRV. The high-level expression of well known inflammatory markers of AECOPD, TNF-α, IL-6 and IL-8 indicates a chronic severe illness. These markers play an important role and could be used as a marker for determining the severity of AECOPD.

Highlights

Chronic obstructive pulmonary disease (COPD) is a common inflammatory and respiratory disease which is preventable and treatable
The COPD severity level in 18 (5.2%) patients were classified as GOLD I, 112 (32.3%) patients as GOLD II, 185 (53.3%) patients as GOLD III and 32 (9.2%) patients as GOLD IV
Our finding was corroborated with the findings from a meta-analysis (pooled prevalence, 0.320 (0.300, 0.340)) which determined the worldwide prevalence of viral infection among Acute exacerbation COPD (AECOPD) patients (Jafarinejad et al, 2017)

Summary

Introduction

Chronic obstructive pulmonary disease (COPD) is a common inflammatory and respiratory disease which is preventable and treatable. It is characterized by persistent respiratory symptoms and irreversible airflow limitation due to airway/alveolar abnormalities caused by noxious particles or gases (WHO, 2019). COPD is higher in patients with smoking history, in those with more than 40 years of age and in men (Halbert et al, 2006). The estimated pooled prevalence of COPD in adults aged more than 40 years of age was 9%-10%. Due to the increase in the aging population in high-income countries and increase in the prevalence of smoking in developing countries, the prevalence of COPD will be on the rise and it was estimated that by 2030 over 4.5 million death may occur due to COPD and related conditions (Lopez et al, 2006)

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