Paplińska-Goryca Magdalena, Rubinsztajn Renata, Nejman-Gryz Patrycja, Przybyłowski Tadeusz, Krenke Rafał, Chazan Ryszarda
a Department of Internal Medicine, Pulmonary Diseases and Allergy , Medical University of Warsaw , Warsaw , Poland.
Scand J Clin Lab Invest. 2017 Dec;77(8):644-650. doi: 10.1080/00365513.2017.1393694. Epub 2017 Oct 25.
Chlamydia pneumoniae is an obligatory human pathogen involved in lower and upper airway infections, including pneumonia, bronchitis. Asymptomatic C. pneumoniae carriage is also relatively common. The association of C. pneumoniae infections with the chronic obstructive pulmonary disease (COPD) course is unclear.
The aim of the study was to investigate the association between chronic C. pneumoniae infection and clinical features of COPD, markers of inflammation and metabolic dysfunction.
The study included 59 patients with stable COPD who had no, or had ≥2 acute exacerbations during last year. The level of IgA and IgG antibody against C. pneumoniae, IL-6, IL-8, resistin, insulin, adiponectin and acyl ghrelin was measured in serum by enzyme-linked immunosorbent assay (ELISA).
No differences in clinical and functional data were observed between COPD patients without serological features of C. pneumoniae infection and chronic C. pneumoniae infection. The level of anti C. pneumoniae IgA significantly correlated with IL-8, IL-6, resistin concentration in group of frequent exacerbators. IgG level correlated negatively with acetyl ghrelin and body mass index (BMI) in patients without frequent exacerbations, in contrast to frequent COPD exacerbation group where significant correlations between IgG level and BMI was demonstrated. Serum IL-6 correlated positively with resistin and insulin and negatively with adiponectin in group of patients with serological features of chronic C. pneumoniae infection only.
Our study showed that chronic C. pneumoniae infection does not influence the clinical course of COPD in the both study groups. Chronic C. pneumoniae infections might be associated with a distinct COPD phenotype that affects metabolic dysfunction.
肺炎衣原体是一种专性人类病原体，可引发下呼吸道和上呼吸道感染，包括肺炎、支气管炎。无症状肺炎衣原体携带也较为常见。肺炎衣原体感染与慢性阻塞性肺疾病（COPD）病程之间的关联尚不清楚。
本研究旨在调查慢性肺炎衣原体感染与COPD临床特征、炎症标志物及代谢功能障碍之间的关联。
本研究纳入了59例稳定期COPD患者，这些患者在过去一年中无急性加重或有≥2次急性加重。采用酶联免疫吸附测定（ELISA）法检测血清中抗肺炎衣原体IgA和IgG抗体、白细胞介素-6（IL-6）、白细胞介素-8（IL-8）、抵抗素、胰岛素、脂联素和酰基胃泌素的水平。
在无肺炎衣原体感染血清学特征的COPD患者与慢性肺炎衣原体感染患者之间，未观察到临床和功能数据的差异。在频繁急性加重组中，抗肺炎衣原体IgA水平与IL-8、IL-6、抵抗素浓度显著相关。在无频繁急性加重的患者中，IgG水平与酰基胃泌素和体重指数（BMI）呈负相关，而在频繁COPD急性加重组中，IgG水平与BMI之间存在显著相关性。仅在具有慢性肺炎衣原体感染血清学特征的患者组中，血清IL-6与抵抗素和胰岛素呈正相关，与脂联素呈负相关。
我们的研究表明，在两个研究组中，慢性肺炎衣原体感染均不影响COPD的临床病程。慢性肺炎衣原体感染可能与影响代谢功能障碍的独特COPD表型相关。
