Section of Experimental Studies, National Heart and Lung Institute, Imperial College London, London, UK NIHR Respiratory Biomedical Research Unit at the Royal Brompton NHS Foundation Trust and Imperial College London, London, UK Department of Pulmonary Medicine, Fukushima Medical University, Fukushima, Japan.
Centre for Respiratory Medicine, University College London Medical School, Royal Free Campus, London, UK.
Thorax. 2014 Oct;69(10):903-9. doi: 10.1136/thoraxjnl-2013-204868. Epub 2014 Jul 17.
Hydrogen sulfide (H₂S) is a gas produced by respiratory cells including smooth muscle cells and may play a role as a cellular gasotransmitter. We evaluated whether H₂S levels in serum or sputum could represent a new biomarker of COPD in a cross-sectional study.
H₂S levels in sputum and serum samples were measured using a sulfide-sensitive electrode in 64 patients with stable COPD (S-COPD), 29 COPD subjects during acute exacerbation (AE-COPD), 14 healthy smokers and 21 healthy non-smokers.
Sputum H₂S levels in AE-COPD subjects were higher than those in S-COPD, healthy smoking and non-smoking subjects (p<0.001), but serum H₂S levels in AE-COPD were lower than those in S-COPD (p<0.001). Thus, the sputum-to-serum ratio of H₂S (H₂S ratio) in AE-COPD subjects were higher than those in stable COPD, healthy smoking and non-smoking subjects (p<0.001). In 14 COPD subjects whose H₂S ratios were measured during and after an exacerbation, the mean ratio was increased during exacerbation (p<0.05). H₂S ratio was positively correlated with St. George's Respiratory Questionnaire score, sputum neutrophils and IL-6 and IL-8 levels in sputum and serum (p<0.01) but inversely correlated with sputum macrophages (%), FEV₁%predicted and FEV₁/FVC (p<0.01). The cut-off level of H₂S ratio to indicate an exacerbation was ≥0.44 (sensitivity of 93.1% and specificity of 84.5%).
The ratio of sputum-to-serum levels of H₂S may provide a useful marker of COPD indicative of obstructive neutrophilic inflammation and of potential ongoing exacerbation.
硫化氢（H₂S）是一种由呼吸细胞（包括平滑肌细胞）产生的气体，可能作为一种细胞气体信号分子发挥作用。我们在一项横断面研究中评估了血清或痰中 H₂S 水平是否可以作为 COPD 的新生物标志物。
使用硫化物敏感电极测量 64 例稳定期 COPD（S-COPD）患者、29 例 COPD 急性加重（AE-COPD）患者、14 例健康吸烟者和 21 例健康非吸烟者的痰和血清样本中的 H₂S 水平。
AE-COPD 患者的痰 H₂S 水平高于 S-COPD、健康吸烟者和非吸烟者（p<0.001），但 AE-COPD 患者的血清 H₂S 水平低于 S-COPD（p<0.001）。因此，AE-COPD 患者的痰-血清 H₂S 比值（H₂S 比值）高于 S-COPD、健康吸烟者和非吸烟者（p<0.001）。在 14 例 COPD 患者中，在加重期间和加重后测量了 H₂S 比值，发现比值在加重期间升高（p<0.05）。H₂S 比值与圣乔治呼吸问卷评分、痰中性粒细胞和 IL-6 及 IL-8 水平呈正相关（p<0.01），与痰巨噬细胞（%）、FEV₁%predicted 和 FEV₁/FVC 呈负相关（p<0.01）。H₂S 比值提示加重的截断值为≥0.44（敏感性为 93.1%，特异性为 84.5%）。
痰-血清 H₂S 比值可能提供 COPD 的有用标志物，提示存在阻塞性中性粒细胞炎症和潜在的持续加重。
