Unidad Medico-Quirurgica de Enfermedades Respiratorias. Hospital Universitario Virgen del Rocio, Seville, Spain.
Int J Med Sci. 2013 Jun 8;10(8):938-47. doi: 10.7150/ijms.6152. Print 2013.
Although researchers have consistently demonstrated systemic inflammation in chronic obstructive pulmonary disease (COPD), its origin is yet unknown. We aimed to compare the lung bronchial and parenchymal tissues as potential sources of major acute-phase reactants in COPD patients and resistant smokers.
Consecutive patients undergoing elective surgery for suspected primary lung cancer were considered for the study. Patients were categorized as COPD or resistant smokers according to their spirometric results. Lung parenchyma and bronchus sections distant from the primary lesion were obtained. C-reactive protein (CRP) and serum amyloid A (SAA1, SAA2 and SAA4) gene expressions were evaluated by RT-PCR. Protein levels were evaluated in paraffin embedded lung tissues by immunohistochemistry and in serum samples by nephelometry.
Our study included 85 patients with COPD and 87 resistant smokers. In bronchial and parenchymal tissues, both CRP and SAA were overexpressed in COPD patients. In the bronchus, CRP, SAA1, SAA2, and SA4 gene expressions in COPD patients were 1.89-fold, 4.36-fold, 3.65-fold, and 3.9-fold the control values, respectively. In the parenchyma, CRP, SAA1, and SAA2 gene expressions were 2.41-, 1.97-, and 1.76-fold the control values, respectively. Immunohistochemistry showed an over-stained pattern of these markers on endovascular cells of COPD patients. There was no correlation with serum protein concentration.
These results indicate an overexpression of CRP and SAA in both bronchial and parenchymal tissue in COPD, which differs between both locations, indicating tissue/cell type specificity. The endothelial cells might play a role in the production of theses markers.
尽管研究人员一致证明慢性阻塞性肺疾病（COPD）存在系统性炎症，但其起源尚不清楚。我们旨在比较肺支气管和实质组织作为 COPD 患者和耐药吸烟者主要急性期反应物的潜在来源。
连续考虑接受择期手术疑似原发性肺癌的患者进行研究。根据其肺量计结果将患者分类为 COPD 或耐药吸烟者。获得远离原发性病变的肺实质和支气管节段。通过 RT-PCR 评估 C 反应蛋白（CRP）和血清淀粉样蛋白 A（SAA1、SAA2 和 SAA4）基因表达。通过免疫组织化学评估石蜡包埋肺组织中的蛋白水平，并通过散射比浊法评估血清样本中的蛋白水平。
我们的研究包括 85 例 COPD 患者和 87 例耐药吸烟者。在支气管和实质组织中，CRP 和 SAA 在 COPD 患者中均过度表达。在支气管中，COPD 患者的 CRP、SAA1、SAA2 和 SA4 基因表达分别是对照值的 1.89 倍、4.36 倍、3.65 倍和 3.9 倍。在实质中，CRP、SAA1 和 SAA2 基因表达分别是对照值的 2.41 倍、1.97 倍和 1.76 倍。免疫组织化学显示 COPD 患者血管内皮细胞存在这些标志物的过度染色模式。与血清蛋白浓度没有相关性。
这些结果表明 CRP 和 SAA 在 COPD 的支气管和实质组织中均过度表达，这在两个部位之间存在差异，表明组织/细胞类型特异性。内皮细胞可能在这些标志物的产生中发挥作用。
