Department of Emergency Medicine (Xie J, Long W), Department of Respiratory Diseases (Shi JD), Shanghai Fifth People's Hospital Affiliated to Fudan University, Shanghai 200240,China; Department of Emergency Medicine (Yang Xing-yi), Changzheng Hospital, Shanghai 200003, China; Department of Emergency Medicine (Deng XQ), Ruijin Group Shanghai Minhang District Central Hospital, Shanghai 201100, China.
World J Emerg Med. 2010;1(3):190-5.
This study was undertaken to measure the concentration of adiponectin (APN) in serum and induced sputum in patients with chronic obstructive pulmonary disease (COPD during acute exacerbation (AECOPD) and at stable stage and to determine the role of APN as a marker of inflammation in the pathogenesis of COPD.
All the patients in this prospective study were enrolled from October 2008 to October 2009, including 30 male AECOPD patients from the emergency department, 30 male stable COPD patients from the department of respiratory diseases, and 30 healthy non-smoking male controls from the department of medical examination. The serum and induced sputum were collected from each patient. All of the patients had normal weight (BMI range 18.5-24.9 kg/m(2)). Patients with severe bronchial asthma, bronchiectasis or autoimmune disease were excluded. Cell count and classification was performed for the induced sputum. The concentrations of APN, IL-8, IL-6 and TNF-α were measured by ELISA. Pulmonary function was tested among the three groups. Comparisons between the groups were conducted by Student's t test, ANOVA analysis or nonparametric test. Correlation analysis was carried out by Pearson's product-moment correlation coefficient test or Spearman's rank-order correlation coefficient test.
The concentrations of APN in the serum or induced sputum in AECOPD patients were significantly higher than those in stable COPD patients or healthy non-smoking controls (P<0.01). The concentration of APN in stable COPD patients was significantly higher than that in healthy non-smoking controls (P<0.01). For the AECOPD patients, APN was positively correlated with IL-8 and TNF-α in the serum and induced sputum (r=0.739, 0.734, 0.852, 0.857 respectively, P<0.05). For the stable COPD patients, APN was also positively correlated with IL-8 and TNF-α in the serum and induced sputum (r=0.751, 0.659, 0.707, 0.867 respectively, P<0.05). In addition, for the AECOPD patients, APN was positively correlated with the percentage of neutrophils in the induced sputum (r=0.439, P<0.05).
APN is involved in the process of systematic and airway inflammation of COPD. This process is related to neutrophils in the airway, IL-8 and TNF-α. APN could be used as a new marker for inflammation of COPD.
本研究旨在测量慢性阻塞性肺疾病（COPD）患者在急性加重期（AECOPD）和稳定期时血清和诱导痰中脂联素（APN）的浓度，并确定 APN 作为 COPD 发病机制中炎症标志物的作用。
本前瞻性研究于 2008 年 10 月至 2009 年 10 月纳入所有患者，包括 30 名来自急诊部的男性 AECOPD 患者、30 名来自呼吸科的男性稳定期 COPD 患者和 30 名来自体检科的健康非吸烟男性对照者。每位患者均采集血清和诱导痰。所有患者体重正常（BMI 范围 18.5-24.9kg/m2）。排除严重支气管哮喘、支气管扩张或自身免疫性疾病患者。对诱导痰进行细胞计数和分类。通过 ELISA 法测定 APN、IL-8、IL-6 和 TNF-α 的浓度。对三组患者进行肺功能测试。通过 Student's t 检验、方差分析或非参数检验进行组间比较。采用 Pearson 积矩相关系数检验或 Spearman 秩相关系数检验进行相关性分析。
AECOPD 患者血清或诱导痰中 APN 的浓度明显高于稳定期 COPD 患者或健康非吸烟对照者（P<0.01）。稳定期 COPD 患者的 APN 浓度明显高于健康非吸烟对照者（P<0.01）。对于 AECOPD 患者，APN 与血清和诱导痰中的 IL-8 和 TNF-α 呈正相关（r=0.739、0.734、0.852、0.857，P<0.05）。对于稳定期 COPD 患者，APN 与血清和诱导痰中的 IL-8 和 TNF-α 也呈正相关（r=0.751、0.659、0.707、0.867，P<0.05）。此外，对于 AECOPD 患者，APN 与诱导痰中中性粒细胞的百分比呈正相关（r=0.439，P<0.05）。
APN 参与 COPD 的全身和气道炎症过程。这一过程与气道中的中性粒细胞、IL-8 和 TNF-α有关。APN 可作为 COPD 炎症的新标志物。
