Karauda Tomasz, Miłkowska-Dymanowska Joanna, Kumor-Kisielewska Anna, Piotrowski Wojciech J, Białas Adam J
Department of Pneumology, Medical University of Lodz, 90-419 Lodz, Poland.
Department of Pulmonary Rehabilitation, Regional Medical Center for Lung Diseases and Rehabilitation, Blessed Rafal Chylinski Memorial Hospital for Lung Diseases, 91-520 Lodz, Poland.
J Clin Med. 2024 Sep 1;13(17):5188. doi: 10.3390/jcm13175188.
Exacerbation of chronic obstructive pulmonary disease (ECOPD) significantly impact health status, hospitalization rates, and disease progression, and are linked to increased mortality. Predictive factors for ECOPD are therefore of considerable interest. The limited understanding of interleukin 16 (IL-16) and IL-25 role in ECOPD provided the rationale for this study. : Fifty ex-smokers diagnosed with COPD (22 ECOPD and 28 patients in the stable phase of the disease) underwent prospective analysis to evaluate the role of I IL-25 as predictive markers of clinical outcomes in ECOPD. We observed a significantly lower IL-16 and higher IL-25 concentrations among ECOPD patients ( = 0.002 and = 0.01 respectively). We also detected a significant negative correlation between IL-16 and neutrophil-to-lymphocyte ratio (NLR) ( = 0.04) and a significant negative correlation between IL-25 concentration and absolute eosinophil count ( = 0.04). In the entire group, we observed a positive correlation between IL-16 and both FEV1 and FVC, both expressed as a percentage of reference value, ( = 0.002 and = 0.0004 respectively). However, after stratification to ECOPD and stable COPD group, significance maintained for FVC ( = 0.045 for ECOPD and = 0.02 for stable COPD). In survival analysis, we detected significantly lower all-cause mortality for 3rd tertile of IL-16 concentrations, with a hazard ratio of 0.33 (95%CI: 0.11-0.98; = 0.04). : Lower IL-16 levels among ECOPD patients may indicate a feedback mechanism linked to heightened Th1 response activation. Observed correlations with ventilatory parameters and survival also seems to reflect this mechanism. The higher IL-25 concentrations observed in ECOPD patients, along with the negative correlation with absolute eosinophil count and eosinopenia, suggest multifactorial regulation and independent functions of eosinophils and IL-25. Hypothetically, this paradox may be related to the Th1/Th2 imbalance favoring Th1 response. Obtained results should be reproduced in larger size samples.
慢性阻塞性肺疾病急性加重（ECOPD）对健康状况、住院率和疾病进展有显著影响，并与死亡率增加相关。因此，ECOPD的预测因素备受关注。对白介素16（IL-16）和白介素25在ECOPD中的作用了解有限，为本研究提供了理论依据。50名被诊断为慢性阻塞性肺疾病的戒烟者（22例ECOPD患者和28例疾病稳定期患者）接受了前瞻性分析，以评估IL-25作为ECOPD临床结局预测标志物的作用。我们观察到ECOPD患者中IL-16浓度显著降低，IL-25浓度显著升高（分别为P = 0.002和P = 0.01）。我们还检测到IL-16与中性粒细胞与淋巴细胞比值（NLR）之间存在显著负相关（P = 0.04），IL-25浓度与绝对嗜酸性粒细胞计数之间存在显著负相关（P = 0.04）。在整个研究组中，我们观察到IL-16与FEV1和FVC均呈正相关，二者均以参考值的百分比表示（分别为P = 0.002和P = 0.0004）。然而，在分层为ECOPD组和稳定期慢性阻塞性肺疾病组后，FVC的相关性仍然显著（ECOPD组P = 0.045，稳定期慢性阻塞性肺疾病组P = 0.02）。在生存分析中，我们检测到IL-16浓度第三分位数的全因死亡率显著降低，风险比为0.33（95%CI：0.11 - 0.98；P = 0.04）。ECOPD患者中较低的IL-16水平可能表明存在一种与Th1反应激活增强相关的反馈机制。观察到的与通气参数和生存的相关性似乎也反映了这种机制。ECOPD患者中观察到的较高IL-25浓度，以及与绝对嗜酸性粒细胞计数和嗜酸性粒细胞减少的负相关，提示嗜酸性粒细胞和IL-25的多因素调节和独立功能。假设，这种矛盾可能与有利于Th1反应的Th1/Th2失衡有关。获得的结果应在更大规模的样本中重现。
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