Abstract
Chronic obstructive pulmonary disease (COPD) is characterised by sputum production, bacterial colonisation, neutrophilic bronchial airway inflammation and poor health status. The aim of this study was to determine the impact of sputum potentially pathogenic microorganisms (PPMs) on bronchial airway inflammation, health status and plasma fibrinogen levels in subjects with moderate-to-severe COPD during the clinical stable state. Sputum total cell and neutrophil counts, supernatant interleukin-8, leukotriene B4, tumour necrosis factor-alpha and neutrophil elastase levels, neutrophil chemotaxis and plasma fibrinogen levels were estimated. Health status was determined using the St George's Respiratory Questionnaire and the 36-item Short-Form Health Survey questionnaire. Twenty-seven (40%) subjects had PPMs and 40 (60%) non-PPMs in their sputum. Both groups were of similar age, body mass index, smoking history and lung function. The PPMs group showed significantly higher levels of interleukin-8, leukotriene B4, tumour necrosis factor-a, neutrophil elastase and increased neutrophil chemotaxis. They also exhibited worse health status and raised plasma fibrinogen levels compared to the non-PPMs group. In conclusion, subjects with clinically stable moderate-to-severe chronic obstructive pulmonary disease who had potentially pathogenic microorganisms in their sputum demonstrated an exaggerated airway inflammatory response, poorer health status and increased plasma fibrinogen levels than those who had nonpotentially pathogenic microorganisms.
Highlights
Impact of sputum bacteria on airway inflammation and health status in clinical stable Chronic obstructive pulmonary disease (COPD)
The aim of the present study was to determine whether patients with COPD harbouring potentially pathogenic microorganisms (PPMs) in their sputum during the clinical stable state have different degrees of airway inflammation, health status and plasma fibrinogen level compared to those stable patients with nonPPMs
The present study has shown that subjects with moderateto-severe COPD who have PPMs in their sputum have an exaggerated airway inflammatory response, worse health status and higher levels of plasma fibrinogen compared to subjects who have non-PPMs in their sputum, even in the clinical stable state
Summary
Impact of sputum bacteria on airway inflammation and health status in clinical stable COPD. The aim of this study was to determine the impact of sputum potentially pathogenic microorganisms (PPMs) on bronchial airway inflammation, health status and plasma fibrinogen levels in subjects with moderate-to-severe COPD during the clinical stable state. The PPMs group showed significantly higher levels of interleukin-8, leukotriene B4, tumour necrosis factor-a, neutrophil elastase and increased neutrophil chemotaxis They exhibited worse health status and raised plasma fibrinogen levels compared to the non-PPMs group. Subjects with clinically stable moderate-to-severe chronic obstructive pulmonary disease who had potentially pathogenic microorganisms in their sputum demonstrated an exaggerated airway inflammatory response, poorer health status and increased plasma fibrinogen levels than those who had nonpotentially pathogenic microorganisms. The presence of bacteria in the lower bronchial airways of patients with stable chronic obstructive pulmonary disease (COPD) has been labelled as colonisation. Bronchoscopic techniques for the study of infections in COPD have confirmed that stable patients often carry bacteria in the lower respiratory tract, and multiple strains, such as nontypeable Haemophilus influenzae, Streptococcus pneumoniae and Moraxella catarrhalis, may be present [1,2,3,4]
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