Abstract
Background/aim: This study performed typing of chronic obstructive pulmonary disease (COPD) using high-resolution computed tomography (HRCT) to determine the association with smoking, matrix metalloproteinases, and common comorbidities. Materials and methods: The study enrolled 94 hospitalized patients. Participants were divided into a group of 69 current and former smokers (group A) and a group of 25 that had never smoked (group B). Patients were also divided into 3 categories according to the degree of emphysema and bronchial wall thickness using HRCT to determine the association with levels of matrix metalloproteinase 9 (MMP-9) and TIMP-1, as well as associated comorbidities. These three categories were: type A - no or mild emphysema, with or without bronchial wall thickening; type E - emphysema without bronchial wall thickening; and type M - both emphysema and bronchial wall thickening. Results: The low attenuation area (LAA) scores in group A patients were higher than those in group B (t = 2.86, P < 0.01); correlation analysis showed that smoking was associated with a decline of the forced expiratory volume in 1 s and forced vital capacity ratio (FEV1/ FVC%) and higher LAA scores in patients with COPD (F = 4.46, F = 8.20, P < 0.05). The levels of MMP-9 in group A were higher than those in group B (t = 3.65, P < 0.01). Among COPD patients with more than 3 comorbidities, there were statistically significant differences in both the smoking group and the nonsmoking group (chi-square = 12.08, P < 0.01). When compared to type A patients, who had coincident cardiovascular diseases in the smoking group, patients of type M and E showed statistically significant differences (F = 2.42 and 2.12, P < 0.05). Conclusion: Emphysema was more severe in smokers. Metalloproteinase levels in smokers were higher than those in nonsmokers. Moreover, comorbidities were more severe in smokers.
Highlights
Pulmonary function testing plays an important role in the diagnosis and evaluation of chronic obstructive pulmonary disease (COPD)
The low attenuation area (LAA) scores in group of current and former smokers (group A) patients were higher than those in group B (t = 2.86, P < 0.01); correlation analysis showed that smoking was associated with a decline of the forced expiratory volume in 1 s and forced vital capacity ratio (FEV1/ FVC%) and higher LAA scores in patients with COPD (F = 4.46, F = 8.20, P < 0.05)
This study examined the use of CT to classify airway inflammation and the association with matrix metalloproteinases and their inhibitors, as well as common comorbidities in COPD patients with and without a smoking history
Summary
Pulmonary function testing plays an important role in the diagnosis and evaluation of chronic obstructive pulmonary disease (COPD). As the severity of COPD cannot be assessed using pulmonary function alone, it is necessary to evaluate airway inflammation, the time of onset, the extent of lung destruction, pathological changes, and associated comorbidities [1,2]. Neutrophils, macrophages, lymphocytes, and inflammatory mediators are involved in airway inflammation and structural damage. Metalloproteinases play a key role in airway and parenchymal structural damage and airflow limitation in COPD [3,4,5]. High-resolution computed tomography (HRCT) can be used to assess the destruction of lung structure in COPD [6] and the findings are associated with pathological changes in COPD [7,8].
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