Department of Respiratory Medicine, the Second Affiliated Hospital of Medical College, Xi'an Jiaotong University, Xi'an 710004, China.
J Thorac Dis. 2014 Jun;6(6):734-41. doi: 10.3978/j.issn.2072-1439.2014.04.31.
Acute exacerbation of chronic obstructive pulmonary disease is associated with increased airway and systemic inflammation. However, the correlation between acute exacerbation/convalescence of chronic obstructive pulmonary disease (COPD) and simultaneous changes of high mobility group protein B1 (HMGB1) and soluble RAGE (sRAGE) levels has not been clearly clarified. The aim of this study was to assess these issues.
A total of 44 COPD patients were recruited. Following a structured interview, plasma levels of HMGB1, sRAGE, fibrinogen and serum level of high-sensitivity C-reactive protein (hsCRP) were measured in patients with acute exacerbation of COPD (AECOPD) within 24 h of hospitalization and pre-discharge (convalescence). All patients were examined with spirometry in convalescence of COPD.
There was a significant decline in plasma HMGB1 (P<0.01), sRAGE (P<0.05), fibrinogen (P<0.01) and serum hsCRP (P<0.01) levels from acute exacerbation to convalescence phase of COPD. Changes of sRAGE was significantly correlated with changes of HMGB1 (r=0.4, P=0.007). COPD disease status correlated with the ratio of HMGB1/sRAGE, but not gender, age, course of disease, smoking history and FEV1% pred. Levels of HMGB1 and sRAGE were the highest in the current smoker group, and significantly decreased in ex-smoker group in both acute exacerbation and convalescence phase of COPD, however, their levels in never smoker group were higher than ex-smoker group in either phase of COPD.
HMGB1 and sRAGE levels were dynamically changed between exacerbation and convalescence phase of COPD, HMGB1 and sRAGE were likely not only a potential marker in COPD exacerbation but also a therapeutic target for COPD treatment.
慢性阻塞性肺疾病（COPD）急性加重与气道和全身炎症的增加有关。然而，COPD 急性加重/缓解期与高迁移率族蛋白 B1（HMGB1）和可溶性 RAGE（sRAGE）水平的同时变化之间的相关性尚不清楚。本研究旨在评估这些问题。
共招募了 44 名 COPD 患者。在住院后 24 小时内和出院前（缓解期）对 COPD 急性加重（AECOPD）患者进行了结构访谈，测定了血浆 HMGB1、sRAGE、纤维蛋白原和血清高敏 C 反应蛋白（hsCRP）水平。所有患者在缓解期均进行了肺功能检查。
从 COPD 的急性加重期到缓解期，血浆 HMGB1（P<0.01）、sRAGE（P<0.05）、纤维蛋白原（P<0.01）和血清 hsCRP（P<0.01）水平均显著下降。sRAGE 的变化与 HMGB1 的变化显著相关（r=0.4，P=0.007）。COPD 疾病状态与 HMGB1/sRAGE 比值相关，但与性别、年龄、病程、吸烟史和 FEV1%预测值无关。HMGB1 和 sRAGE 水平在当前吸烟者组中最高，在 COPD 急性加重和缓解期的戒烟者组中均显著降低，而在 COPD 任何阶段的从不吸烟者组中，其水平均高于戒烟者组。
HMGB1 和 sRAGE 水平在 COPD 加重和缓解期之间呈动态变化，HMGB1 和 sRAGE 不仅可能是 COPD 加重的潜在标志物，也是 COPD 治疗的潜在靶点。
