Department of Pathophysiology, National Koranyi Institute of TB and Pulmonology, Budapest, Hungary.
Respiration. 2014;87(5):408-15. doi: 10.1159/000358099. Epub 2014 Apr 4.
Eicosanoids are small lipid molecules with diverse biological functions in the airways.
The aim of this study was to investigate changes in leukotriene B4 (LTB4), 8-isoprostane, prostaglandin E2 (PGE2) and cysteinyl-leukotriene (cys-LT) levels in the sputum of patients with chronic obstructive pulmonary disease (COPD) at the onset of a severe exacerbation and during the course of recovery.
Thirty-seven ex-smoker COPD patients suffering an episode of acute exacerbation were enrolled. Samples were taken (i) on hospital admission and (ii) after regular treatment. Twenty-five stable ex-smoker COPD patients served as controls. Eicosanoids were determined by enzyme immunoassay.
Sputum PGE2 [39.8 (13.3-103.3) vs. 5.05 (2.3-12.1) pg/ml, p < 0.001], 8-isoprostane [89.5 (36.9-184.7) vs. 29.7 (13.8-68.8) pg/ml, p < 0.01] and LTB4 [587.7 (252.9-774.8) vs. 276.1 (105.4-594.7) pg/ml, p < 0.05] levels were increased in patients with exacerbation compared to stable subjects. After treatment only PGE2 levels decreased significantly [at discharge: 19.6 (4.6-52.5) pg/ml, p < 0.01], the levels of other eicosanoids remained elevated (p = NS). Sputum cys-LT levels were similar in stable patients and in those with exacerbation and treatment did not influence cys-LTs either. There was a significant correlation between PGE2 and sputum neutrophil and lymphocyte cell counts in patients with exacerbation.
Our results suggest that 8-isoprostane, LTB4 and PGE2 but not cys-LTs may be involved in exacerbation-associated inflammatory processes in the airways of patients with COPD. Validation of PGE2 for use as a biomarker of recovery from an exacerbation requires further studies.
二十烷类是气道中具有多种生物学功能的小脂质分子。
本研究旨在探讨慢性阻塞性肺疾病（COPD）患者在严重加重期开始时和恢复期痰液中白三烯 B4（LTB4）、8-异前列腺素、前列腺素 E2（PGE2）和半胱氨酰白三烯（cys-LT）水平的变化。
纳入 37 名患有 COPD 的戒烟吸烟者，他们患有急性加重期。样本采集时间为：（i）入院时和（ii）常规治疗后。25 名稳定的戒烟 COPD 患者作为对照。采用酶免疫法测定二十烷类物质。
与稳定期患者相比，加重期患者的痰液 PGE2[39.8（13.3-103.3）与 5.05（2.3-12.1）pg/ml，p<0.001]、8-异前列腺素[89.5（36.9-184.7）与 29.7（13.8-68.8）pg/ml，p<0.01]和 LTB4[587.7（252.9-774.8）与 276.1（105.4-594.7）pg/ml，p<0.05]水平升高。治疗后仅 PGE2 水平显著下降[出院时：19.6（4.6-52.5）pg/ml，p<0.01]，其他二十烷类物质水平仍升高（p=NS）。稳定患者和加重患者的痰液 cys-LT 水平相似，治疗也不影响 cys-LTs。加重患者痰液 PGE2 与中性粒细胞和淋巴细胞计数呈显著相关。
我们的结果表明，8-异前列腺素、LTB4 和 PGE2 但不是 cys-LTs 可能参与 COPD 患者气道加重相关炎症过程。进一步研究需要验证 PGE2 是否可作为急性加重恢复期的生物标志物。
