Abstract

BackgroundSystemic manifestations and comorbidities are characteristics of chronic obstructive pulmonary disease (COPD) and are probably due to systemic inflammation. The histone methyltransferase SUV39H1 controls the Th1/Th2 balance. We previously reported that reduced SUV39H1 expression contributed to abnormal inflammation in COPD. Here, we aimed to determine whether impaired SUV39H1 expression in COPD patients associated with neutrophilic/eosinophilic inflammation responses and comorbidities.MethodsA total of 213 COPD patients and 13 healthy controls were recruited from the Shuang Ho Hospital, Taipei Medical University. SUV39H1 levels in peripheral blood mononuclear cells (PBMCs) from 13 healthy and 30 COPD participants were measured by immunoblotting. We classified the patients into two groups based on low (fold change, FC < 0.5) and high SUV39H1 expression (FC ≥ 0.5) compared to normal controls. Clinical outcomes including neutrophil or eosinophil counts associated with SUV39H1-related inflammation were evaluated by Chi square analyses or Mann–Whitney U test. The correlations between the percentage of neutrophils and number of COPD comorbidities or Charlson Comorbidity Index (CCI) scores were performed by Spearman’s rank analysis.ResultsLow SUV39H1 expression group had high neutrophil counts relative to high SUV39H1expression group. In the COPD cohort, the high comorbidity group (≥ 2 comorbidities) had higher counts of whole white blood cell (WBC) and neutrophil, and lower proportion of eosinophil and eosinophil/neutrophil, as compared with low comorbidity group (0 and 1 comorbidities). The quantity of neutrophils was associated with COPD comorbidities (Spearman's r = 0.388, p < 0.001), but not with CCI scores. We also found that the high comorbidity group had more exacerbations per year compared with low comorbidity group (1.5 vs. 0.9 average exacerbations, p = 0.005). However, there were no significant differences between groups with these non-frequent (0–1 exacerbation) and frequent exacerbations per year (> 1 exacerbation) in numbers of WBC and proportion of neutrophils, eosinophils or eosinophil/neutrophil. Finally, patients with high comorbidities had lower SUV39H1 levels in their PBMCs than did those with low comorbidities.ConclusionBlood neutrophil counts are associated with comorbidities in COPD patients. Impaired SUV39H1 expression in PBMCs from COPD patients are correlated with neutrophilic inflammation and comorbidities.

Highlights

  • Systemic manifestations and comorbidities are characteristics of chronic obstructive pulmonary disease (COPD) and are probably due to systemic inflammation

  • Impaired Sup‐ pressor of variegation 3–9 homolog 1 (SUV39H1) expres‐ sion in peripheral blood mononuclear cells (PBMCs) from COPD patients are correlated with neutrophilic inflammation and comorbidities

  • We found that the high comorbidity group had a lower BMI (22.78 ± 5.41 vs 23.9 ± 3.41, p = 0.026), a smaller percentage of Group A COPD patients (35.5% vs. 59.6%, p = 0.0014), higher percentages of GOLD 4 (22.6% vs. 7.3%, p = 0.002) and Group D COPD patients (32.3% vs. 13.9%, p = 0.002), higher total leukocyte counts (9,187/μL vs. 7,983/μL, p = 0.012), a higher neutrophil percentage (69.8% vs. 60.7%, p < 0.001), a lower eosinophil percentage (2.3% vs. 3.3%, p = 0.037), and a lower eosinophil/neutrophil ratio (4.1% vs. 6.03%, p < 0.001) (Fig. 4)

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Summary

Introduction

Systemic manifestations and comorbidities are characteristics of chronic obstructive pulmonary disease (COPD) and are probably due to systemic inflammation. We previously reported that reduced SUV39H1 expression contributed to abnormal inflammation in COPD. We aimed to determine whether impaired SUV39H1 expression in COPD patients associated with neutro‐ philic/eosinophilic inflammation responses and comorbidities. Chronic obstructive pulmonary disease (COPD) is a chronic inflammatory airway disease with systemic manifestations and comorbidities, e.g., osteoporosis, hyperglycaemia, cardiovascular dysfunction, and even different malignant neoplasms [1]. Current pharmacological therapy, which is mainly focused treating on airway inflammation and airflow limitation, effectively relieves symptoms, improves the health status, and reduces exacerbations, a decrease in mortality has not been confirmed. In addition to developing more effective treatments for airway issue, a strategy to combat systemic effects, probably by targeting systemic inflammation, is urgently needed

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