Abstract
This article presents data on the influence of enzymatic activity of serum on the processes of liver fibrosis in patients with non-alcoholic fatty liver disease (NAFLD) and chronic obstructive pulmonary disease (COPD). Clinical, biochemical, immunological research methods and enzyme-linked immunosorbent assay (ELISA) were used in the work. All patients were determined for the degree of liver fibrosis using a non-invasive method – Fibromax. It was found that in patients with NAFLD and COPD with frequent exacerbations, the levels of CRP, IL-6, TNF-α and neopterin are significantly higher than in patients who had one or no exacerbation of COPD. Stably high levels of systemic inflammation markers of TNF-α, neopterin, CRP lead to the activation of TGF-β, which increases with the deepening stage of liver fibrosis. The average values of IgG antibodies to neutrophil elastase significantly increase depending on the stage of fibrotic changes in the liver and the activity of inflammatory changes in it, with the highest concentration in fibrosis F2. In F3-4 fibrosis, the levels of antibodies to elastase are reduced, although they remain higher than the control values. Significant increase IgG antibody levels to neutrophil elastase depending on the stage of fibrosis and the activity of inflammatory changes indicates the role of serum enzymatic activity in the mechanisms of formation of more severe stages of NAFLD and can be considered as additional diagnostic markers.
Highlights
There is a strong justification for supporting the hypothesis of an increase in the prevalence of nonalcoholic fatty liver disease (NAFLD) in patients with chronic obstructive pulmonary disease (COPD) (Chan, Stanley et al, 2019)
There is strong evidence that pneumonia during COPD leads to an increase the number of biomarkers associated with neutrophilic inflammation (MMP9, elastase, calprotectin) and proinflammatory cytokines (IL-6, IL-1β, IFN-α, CRP, TNF-a,) "in the lungs and bronchi", and in the peripheral blood, which indicates the presence of a systemic inflammatory reaction or systemic inflammation and plays an important role in pathophysiology of COPD and its comorbidities such as metabolic syndrome (Yazici et al.,2020; Huang et al, 2019)
48 (2021) 5 of this study showed that in patients with COPD comorbid with frequent exacerbations, the levels of CRP, IL-6, TNF-α and neopterin are significantly higher even in the remission phase of COPD, and than in patients who had one or did not tolerate any exacerbation for the last year
Summary
There is a strong justification for supporting the hypothesis of an increase in the prevalence of nonalcoholic fatty liver disease (NAFLD) in patients with chronic obstructive pulmonary disease (COPD) (Chan, Stanley et al, 2019). There is strong evidence that pneumonia during COPD leads to an increase the number of biomarkers associated with neutrophilic inflammation (MMP9, elastase, calprotectin) and proinflammatory cytokines (IL-6, IL-1β, IFN-α, CRP, TNF-a,) "in the lungs and bronchi", and in the peripheral blood, which indicates the presence of a systemic inflammatory reaction or systemic inflammation and plays an important role in pathophysiology of COPD and its comorbidities such as metabolic syndrome (Yazici et al.,2020; Huang et al, 2019). 48 (2021) 5 of NAFLD with high inflammatory activity and increased hepatic steatosis. The exact mechanisms of the pathogenesis of the transition from steatosis to fibrosis in patients with NAFLD under the condition of comorbidity of COPD have not been fully established
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