Department of Respiratory and Critical Care Medicine, Hangzhou TCM Hospital Affiliated to Zhejiang Chinese Medical University, Hangzhou City, Zhejiang Province, People's Republic of China.
Int J Chron Obstruct Pulmon Dis. 2024 Nov 1;19:2361-2369. doi: 10.2147/COPD.S490152. eCollection 2024.
To explore the predictive value of cellular inflammatory factors and T cell subsets for disease recurrence and prognosis in patients with acute exacerbations of chronic obstructive pulmonary disease (COPD).
Serum samples were collected from the two groups to detect and compare the levels of inflammatory cytokines [interleukin-1β (IL-1β), interleukin-6 (IL-6), tumor necrosis factor-α (TNF-α)], T cell subsets (CD4+, CD8+), and clinical related indicators. Pearson correlation analysis was used to analyze the correlation between inflammatory cytokines, T cell subsets, and clinical indicators. Receiver operating characteristic (ROC) curves were plotted to analyze the predictive value of serum inflammatory factors and T cell subsets for acute exacerbations of COPD.
The observation group had higher levels of IL-1β, IL-6, TNF-α, and CD8+, and lower CD4+ levels (P<0.05). The ratio of forced expiratory volume in 1 second to forced vital capacity (FEV1/FVC) was lower, while procalcitonin (PCT) and white blood cell count (WBC) were higher (P<0.05). Correlation analysis showed positive correlations between IL-1β, IL-6, TNF-α, and CD8+, and negative correlations with CD4+ and FEV1/FVC (P<0.05). After 6 months, 15 out of 73 patients had acute recurrences, with higher IL-1β, IL-6, TNF-α, and CD8+ levels (P<0.05). Binary logistic regression identified IL-1β, IL-6, TNF-α, and CD8+ as significant predictors of exacerbations, while CD4+ was protective. ROC analysis showed that combined biomarkers had the highest predictive efficiency (AUC = 0.907).
This study is the first to integrate multiple serum inflammatory factors and T cell subsets into a comprehensive predictive model for acute recurrence of COPD within six months (AUC = 0.907), offering a more accurate prediction than traditional methods. The findings underscore the value of these biomarkers in clinical follow-up and highlight their independent predictive power, providing new insights into the interaction between immune markers and clinical indicators in COPD exacerbations.
探讨细胞炎性因子和 T 细胞亚群对慢性阻塞性肺疾病（COPD）急性加重患者疾病复发和预后的预测价值。
收集两组患者的血清样本，检测并比较炎性细胞因子[白细胞介素-1β（IL-1β）、白细胞介素-6（IL-6）、肿瘤坏死因子-α（TNF-α）]、T 细胞亚群（CD4+、CD8+）和临床相关指标的水平。采用 Pearson 相关性分析炎性细胞因子、T 细胞亚群与临床指标的相关性。绘制受试者工作特征（ROC）曲线分析血清炎性因子和 T 细胞亚群对 COPD 急性加重的预测价值。
观察组的 IL-1β、IL-6、TNF-α、CD8+水平较高，CD4+水平较低（P<0.05）。1 秒用力呼气容积占用力肺活量的比值（FEV1/FVC）较低，降钙素原（PCT）和白细胞计数（WBC）较高（P<0.05）。相关性分析显示，IL-1β、IL-6、TNF-α、CD8+与 CD4+、FEV1/FVC 呈正相关（P<0.05）。6 个月后，73 例患者中有 15 例急性复发，IL-1β、IL-6、TNF-α、CD8+水平较高（P<0.05）。二元逻辑回归分析显示，IL-1β、IL-6、TNF-α、CD8+是加重的显著预测因子，而 CD4+是保护性的。ROC 分析显示，联合生物标志物具有最高的预测效率（AUC = 0.907）。
本研究首次将多种血清炎性因子和 T 细胞亚群整合到一个综合预测模型中，预测 COPD 患者在 6 个月内的急性复发（AUC = 0.907），比传统方法更准确。研究结果强调了这些生物标志物在临床随访中的价值，并突显了它们独立的预测能力，为 COPD 加重过程中免疫标志物与临床指标的相互作用提供了新的见解。
