Foschino Barbaro M P, Carpagnano G E, Spanevello A, Cagnazzo M G, Barnes P J
Institute of Respiratory Disease, Department of Medical and Occupational Sciences, University of Foggia, Italy.
Int J Immunopathol Pharmacol. 2007 Oct-Dec;20(4):753-63. doi: 10.1177/039463200702000411.
Chronic obstructive pulmonary diseases (COPD) is a pulmonary disease characterized by systemic abnormalities. The aim of this study is to investigate inflammation and systemic effects in mild COPD. Twenty-seven mild stable smoking related COPD patients and 15 age-matched healthy subjects were enrolled in the study. IL-6, TNF-alpha and IL-4 in plasma, sputum and exhaled breath condensate were measured. We also measured exhaled nitric oxide (NO) and pH in sputum and in breath condensate. Moreover, fat-free mass, body mass index (BMI), respiratory muscle strength, plasma oxidative stress and C-reactive protein (CRP) were measured. Higher concentrations were found of CRP, of diacron reactive oxygen metabolites (DROMs) and of IL-6, TNF-alpha and IL-4 either in plasma or in supernatant of induced sputum or in exhaled breath condensate of COPD subjects compared to healthy controls. Furthermore, higher concentrations were observed of exhaled NO and lower exhaled pH in breath condensate of COPD when compared with healthy subjects. In the group of COPD patients, the subjects with airway reversibility showed an increase of sputum eosinophils and exhaled NO, whereas the subjects without airway obstruction reversibility showed an increase in sputum neutrophils, TNF-alpha and IL-6. We also found a trend towards a decrease in fat-free mass and respiratory muscle strength in COPD compared to healthy subjects and a negative correlation between these systemic indices (fat-free mass, maximal inspiratory pressure, maximal expiratory pressure) and TNF-alpha concentrations in the blood, sputum and breath condensate. We conclude that mild COPD subjects present an increase in inflammatory markers in blood and in airways of similar pattern and furthermore, the neutrophilic pattern of airway inflammation observed in the group of COPD subjects without an airway obstruction reversibility makes it more likely that systemic features are present.
慢性阻塞性肺疾病(COPD)是一种以全身异常为特征的肺部疾病。本研究旨在调查轻度COPD中的炎症和全身影响。27例轻度稳定的吸烟相关性COPD患者和15例年龄匹配的健康受试者纳入本研究。测量血浆、痰液和呼出气冷凝物中的白细胞介素-6(IL-6)、肿瘤坏死因子-α(TNF-α)和白细胞介素-4。我们还测量了痰液和呼出气冷凝物中的呼出一氧化氮(NO)和pH值。此外,测量了去脂体重、体重指数(BMI)、呼吸肌力量、血浆氧化应激和C反应蛋白(CRP)。与健康对照相比,COPD患者血浆、诱导痰液上清液或呼出气冷凝物中的CRP、戴克隆活性氧代谢产物(DROMs)、IL-6、TNF-α和IL-4浓度更高。此外,与健康受试者相比,COPD患者呼出气冷凝物中的呼出NO浓度更高,呼出pH值更低。在COPD患者组中,具有气道可逆性的受试者痰液嗜酸性粒细胞和呼出NO增加,而无气道阻塞可逆性的受试者痰液中性粒细胞、TNF-α和IL-6增加。我们还发现,与健康受试者相比,COPD患者的去脂体重和呼吸肌力量有下降趋势,并且这些全身指标(去脂体重、最大吸气压、最大呼气压)与血液、痰液和呼出气冷凝物中的TNF-α浓度呈负相关。我们得出结论,轻度COPD受试者血液和气道中的炎症标志物呈现相似模式的增加,此外,在无气道阻塞可逆性的COPD受试者组中观察到的气道炎症中性粒细胞模式使其更有可能存在全身特征。