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慢性阻塞性肺疾病(COPD)和哮喘急性加重期炎症生物标志物的研究。

Study of inflammatory biomarkers in COPD and asthma exacerbations.

作者信息

Vassiliou Alice G, Vitsas Vlassios, Kardara Matina, Keskinidou Chrysi, Michalopoulou Pinelopi, Rovina Nikoletta, Dimopoulou Ioanna, Orfanos Stylianos E, Tsoukalas Georgios, Koutsoukou Antonia, Kotanidou Anastasia

机构信息

1st Department of Critical Care Medicine & Pulmonary Services, National and Kapodistrian University of Athens, Medical School, Evangelismos Hospital, Athens, Greece, Athens.

4th Pulmonary Department, Sotiria Chest Disease Hospital, Athens, Greece.

出版信息

Adv Respir Med. 2020;88(6):558-566. doi: 10.5603/ARM.a2020.0188.

Abstract

INTRODUCTION

Exacerbations are critical events in the course of asthma and chronic obstructive pulmonary disease (COPD). These events are potentially life-threatening, and the studies have shown that they have tremendous implications on long-term disease control and the overall prognosis of the patients. The aim of this study was to examine adipokines, cytokines and C-reactive protein (CRP) as potential biomarkers in asthma and COPD.

MATERIAL AND METHODS

Prospective cohort study of COPD and asthma patients treated for acute exacerbations. Thirty-nine COPD patients and 15 asthmatic patients were included in the study. Leptin, adiponectin, resistin, interleukin (Il)-6, 8, 18, tumor necrosis factor-a (TNF-a), and CRP were measured at three time points: on admission, at resolution and at the stable phase. Pre- and post-bronchodilation spirometry was additionally performed at resolution and at the stable phase.

RESULTS

In COPD patients, leptin, leptin/adiponectin (L/A) ratio and resistin were elevated on admission compared to the stable phase. In asthmatic patients, leptin levels were raised on admission compared to the stable phase, and adiponectin was elevated at resolution compared to admission. In both diseases, CRP was significantly increased on admission compared to both resolution and stable disease. Finally, TNF-a could distinguish between asthma and COPD stable phase.

CONCLUSIONS

Leptin and CRP levels may be useful biomarkers in monitoring COPD and asthma response to treatment during an exacerbation episode. Hypoadiponectinemia was detected in asthma and COPD during all stages of the diseases. TNF-a could distinguish between asthma and COPD stable phase.

摘要

引言

急性加重是哮喘和慢性阻塞性肺疾病(COPD)病程中的关键事件。这些事件具有潜在的生命威胁,并且研究表明它们对疾病的长期控制和患者的总体预后具有重大影响。本研究的目的是检测脂肪因子、细胞因子和C反应蛋白(CRP)作为哮喘和COPD潜在生物标志物的情况。

材料与方法

对因急性加重接受治疗的COPD和哮喘患者进行前瞻性队列研究。39例COPD患者和15例哮喘患者纳入研究。在三个时间点测量瘦素、脂联素、抵抗素、白细胞介素(Il)-6、8、18、肿瘤坏死因子-α(TNF-α)和CRP:入院时、病情缓解时和稳定期。在病情缓解时和稳定期还额外进行了支气管扩张前后的肺功能测定。

结果

在COPD患者中,入院时瘦素、瘦素/脂联素(L/A)比值和抵抗素水平高于稳定期。在哮喘患者中,入院时瘦素水平高于稳定期,病情缓解时脂联素水平高于入院时。在两种疾病中,入院时CRP水平均显著高于病情缓解时和疾病稳定期。最后,TNF-α可以区分哮喘和COPD的稳定期。

结论

瘦素和CRP水平可能是监测COPD和哮喘急性加重期治疗反应的有用生物标志物。在哮喘和COPD的所有阶段均检测到低脂联素血症。TNF-α可以区分哮喘和COPD的稳定期。

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