Kaźmierczak Marcin, Ciebiada Maciej, Pękala-Wojciechowska Anna, Pawłowski Maciej, Nielepkowicz-Goździńska Agnieszka, Antczak Adam
Department of Internal Medicine, Asthma and Allergy, Lodz, Poland.
Department of General and Oncological Pneumology, Medical University of Lodz, Lodz, Poland.
Heart Lung Circ. 2015 Aug;24(8):817-23. doi: 10.1016/j.hlc.2015.01.019. Epub 2015 Feb 20.
Although both chronic obstructive pulmonary disease (COPD) and cardiovascular diseases (CVD) are characterised by chronic, systemic inflammation, their reciprocal interactions are poorly understood. The purpose of this study was to determine the concentrations of both inflammatory and oxidative stress biomarkers in the serum and exhaled breath condensate (EBC) of COPD patients, either with coexisting CVD or without cardio-vascular comorbidities.
Twenty-four COPD patients with CVD were allocated to group A, 20 COPD patients without CVD were assigned to group B and 16 healthy patients were included as a control. A medical history and physical examination were performed, and the following were measured: serum CRP concentration, glucose level, uraemic acid level and lipid profile. In addition 8-isoprostane, LTB4 and IL-8 concentrations were measured both in serum and EBC. Spirometry, six-minute walk test and echocardiography were performed in all subjects.
EBC concentrations of 8-isoprostane and LTB4, and serum levels of CRP, 8-soprostane, LTB4, IL-8 were significantly higher in COPD patients than in healthy controls. COPD patients with CVD were not found to have higher concentrations of the assessed markers than those without CVD, neither in the serum nor EBC. CRP, 8-isoprostane and LTB4 levels in serum, and IL-8 concentration in EBC correlated negatively with the value of forced expiratory volume in one second.
Although systemic inflammation coexists with COPD, it is not elevated in COPD patients with CVD. Since this phenomenon may result from treatment with statins, future studies should state whether COPD patients could benefit from the additional statin therapy.
尽管慢性阻塞性肺疾病（COPD）和心血管疾病（CVD）均以慢性全身性炎症为特征，但它们之间的相互作用却鲜为人知。本研究的目的是测定合并心血管疾病（CVD）或无心血管合并症的COPD患者血清和呼出气冷凝液（EBC）中炎症和氧化应激生物标志物的浓度。
将24例合并CVD的COPD患者分为A组，20例无CVD的COPD患者分为B组，纳入16例健康患者作为对照。进行病史采集和体格检查，并测量以下指标：血清CRP浓度、血糖水平、尿酸水平和血脂谱。此外，还测定了血清和EBC中的8-异前列腺素、白三烯B4（LTB4）和白细胞介素-8（IL-8）浓度。对所有受试者进行肺功能测定、6分钟步行试验和超声心动图检查。
COPD患者EBC中的8-异前列腺素和LTB4浓度以及血清中的CRP、8-异前列腺素、LTB4、IL-8水平均显著高于健康对照组。未发现合并CVD的COPD患者血清和EBC中所评估标志物的浓度高于无CVD的患者。血清中的CRP、8-异前列腺素和LTB4水平以及EBC中的IL-8浓度与一秒用力呼气量值呈负相关。
尽管全身性炎症与COPD并存，但合并CVD的COPD患者炎症并未加剧。由于这种现象可能是他汀类药物治疗的结果，未来的研究应阐明COPD患者是否能从额外的他汀类药物治疗中获益。
