[The influence of inflammatory process on the ventilatory impairment in patients with stable chronic obstructive pulmonary disease].

INTRODUCTION

At present, COPD is known to be a systemic disease resulting from generalized inflammation which affects the function of many organs. Generalized inflammation is recognized from increased serum concentration of inflammatory cytokines. The aim of the present study was to investigate the influence of inflammatory process on the respiratory impairment in patients with stable chronic obstructive pulmonary disease.

MATERIAL AND METHODS

A group of 60 stable COPD patients (GOLD stages I-IV) participated in the study. Inclusion criteria were: confirmed diagnosis of chronic obstructive pulmonary disease, clinical stable state, established treatment which had not been changed for at least 3 months prior to the study or in the course of the study. Exclusion criteria included coexistence of other diseases and/or medication causing an increase of markers of inflammation. In all patients inflammatory markers (serum concentration of fibrinogen, hs-CRP, IL-6, TNF-alpha) were determined. In order to assess the stage of COPD, bodyplethysmography with bronchodilating test was conducted and lung hyperinflation parameters were assessed.

RESULTS

Analysis of relationship between markers of systemic inflammation and spirometry variables revealed a significant negative correlation between the level of hs-CRP and signs of hyperinflation; IC% of predicted value (r(s) = -0.29; p = 0.023) and IC/TLC (r(s) = -0.32; p = 0.014). The IC/TLC index also tended to be related to the concentration of fibrinogen. Higher fibrinogen concentrations were associated with lower IC/TLC values, albeit without statistical significance (r(s) = -0.23; p = 0.074). There was a positive relationship between serum concentration of TNF-alpha and arterial blood carbon dioxide pressure PaCO(2) (r = 0.281; p = 0.03) as well as right ventricle systolic pressure RVSP in echocardiography (r = 0.332; p = 0.01).

CONCLUSIONS

Severity of hyperinflation progression may be associated with the increase of inflammatory process in patients with stable COPD. Inflammatory process may have an adverse affect on the respiratory system increasing significantly static lung hyperinflation.