Servei de Pneumologia, Hospital Universitari Son Dureta, C/Andrea Doria 55, Palma de Mallorca, Spain.
Respiration. 2010;80(3):190-7. doi: 10.1159/000264604. Epub 2009 Dec 2.
It is known that pro-inflammatory cytokines suppress in vitro the gene expression and protein production of erythropoietin (Epo). We hypothesized that systemic inflammation in patients with chronic obstructive pulmonary disease (COPD) may influence Epo production, particularly during episodes of exacerbation of the disease (ECOPD) where an inflammatory burst is known to occur.
We compared the plasma levels of Epo and high-sensitivity (hs) C-reactive protein (hsC-RP) in patients hospitalized because of ECOPD (n = 26; FEV(1): 48 +/- 15% predicted), patients with clinically stable COPD (n = 31; FEV(1): 49 +/- 17% predicted), smokers with normal lung function (n = 9), and healthy never smokers (n = 9).
Venous blood samples were taken between 9 and 10 a.m. after an overnight fast into tubes with EDTA (10 ml) or without EDTA (10 ml). Plasma levels of Epo (R&D Systems Inc., Minneapolis, Minn., USA) and hsC-RP (BioSource, Belgium) were determined by ELISA.
Log-Epo plasma levels were significantly lower (0.46 +/- 0.32 mU/ml) in ECOPD than in stable COPD (1.05 +/- 0.23 mU/ml), smokers (0.95 +/- 0.11 mU/ml) and never smokers with normal lung function (0.92 +/- 0.19 mU/ml) (p < 0.01, each). In a subset of 8 COPD patients who could be studied both during ECOPD and clinical stability, log-Epo increased from 0.49 +/- 0.42 mU/ml during ECOPD to 0.97 +/- 0.19 mU/ml during stability (p < 0.01). In patients with COPD log-Epo was significantly related to hsC-RP (r = -0.55, p < 0.0001) and circulating neutrophils (r = -0.48, p < 0.0001).
These results show that the plasma levels of Epo are reduced during ECOPD likely in relation to a burst of systemic inflammation.
已知促炎细胞因子可抑制红细胞生成素（Epo）的基因表达和蛋白产生。我们假设慢性阻塞性肺疾病（COPD）患者的全身炎症可能会影响 Epo 的产生，特别是在疾病加重（ECOPD）期间，已知会发生炎症爆发。
我们比较了因 ECOPD 住院的患者（n = 26；FEV1：48 +/- 15%预测值）、临床稳定 COPD 患者（n = 31；FEV1：49 +/- 17%预测值）、肺功能正常的吸烟者（n = 9）和健康从不吸烟者（n = 9）的血浆 Epo 和高敏（hs）C-反应蛋白（hsC-RP）水平。
在禁食过夜后，于上午 9 点至 10 点之间，将静脉血样采集到含有 EDTA（10ml）或不含 EDTA（10ml）的管中。通过 ELISA 测定 Epo（R&D Systems Inc.，明尼苏达州明尼阿波利斯市）和 hsC-RP（BioSource，比利时）的血浆水平。
ECOPD 患者的 Log-Epo 血浆水平明显低于稳定 COPD（1.05 +/- 0.23 mU/ml）、吸烟者（0.95 +/- 0.11 mU/ml）和肺功能正常的从不吸烟者（0.92 +/- 0.19 mU/ml）（p < 0.01，均）。在 8 例 COPD 患者的亚组中，这些患者可在 ECOPD 和临床稳定期间进行研究，Log-Epo 从 ECOPD 期间的 0.49 +/- 0.42 mU/ml 增加到稳定期间的 0.97 +/- 0.19 mU/ml（p < 0.01）。在 COPD 患者中，Log-Epo 与 hsC-RP（r = -0.55，p < 0.0001）和循环中性粒细胞（r = -0.48，p < 0.0001）呈显著相关。
这些结果表明，Epo 的血浆水平在 ECOPD 期间降低，可能与全身炎症爆发有关。
