Abstract
Little is known about airway inflammatory markers in chronic obstructive pulmonary disease (COPD). The objective of the present study was to identify and try to correlate pulmonary and peripheral blood inflammatory markers in COPD. In a cross-sectional study on patients with stable COPD, induced sputum and blood samples were collected for the determination of C-reactive protein, eosinophilic cationic protein, serum amyloid A protein, alpha-1 antitrypsin (alpha-1AT), and neutrophil elastase. Twenty-two patients were divided into two groups according to post-bronchodilator forced expiratory volume in the first second (%FEV1): group 1 (N = 12, FEV1 <40%) and group 2 (N = 10, FEV1 > or =40%). An increase in serum elastase, eosinophilic cationic protein and alpha-1AT was observed in serum markers in both groups. Cytology revealed the same total number of cells in groups 1 and 2. There was a significantly higher number of neutrophils in group 1 compared to group 2 (P < 0.05). No difference in eosinophils or macrophages was observed between groups. Serum elastase was positively correlated with serum alpha-1AT (group 1, r = 0.81, P < 0.002 and group 2, r = 0.83, P < 0.17) and negatively correlated with FEV1 (r = -0.85, P < 0.03 and -0.14, P < 0.85, respectively). The results indicate the presence of chronic and persistent pulmonary inflammation in stable patients with COPD. Induced sputum permitted the demonstration of the existence of a subpopulation of cells in which neutrophils predominated. The serum concentration of all inflammatory markers did not correlate with the pulmonary functional impairment.
Highlights
Chronic obstructive pulmonary disease (COPD) has recently been defined as a systemic pulmonary inflammatory disease whose physiopathology is poorly understood [1], with a growing interest in the understanding of the relationship between systemic inflammation and pulmonary events [2]
The results obtained for patients with moderate and severe COPD, indicated the presence of chronic and persistent pulmonary inflammation in stable patients
Serum inflammatory markers did not correlate with the degree of pulmonary function impairment in this group of stable patients with COPD
Summary
Chronic obstructive pulmonary disease (COPD) has recently been defined as a systemic pulmonary inflammatory disease whose physiopathology is poorly understood [1], with a growing interest in the understanding of the relationship between systemic inflammation and pulmonary events [2]. Systemic inflammation has been recognized as an important risk factor for a diverse number of co-morbidities including atherosclerosis [3], cachexia [4], anorexia [5], and osteoporosis [6]. All of these complications are commonly observed in patients with COPD [7]. The extent of systemic inflammation in stable patients and the nature of the inflammatory markers present during the chronic phase of the disease have not been demonstrated. Creactive protein is an acute-phase protein and a sensitive indicator of systemic inflammation
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